Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 125057703 | IL |
N | 111NI0900X | Internist | 125057703 | IL |
N | 207R00000X | Internist | C168707 | CA |
N | 111NI0900X | Internist | C168707 | CA |
Y | 207RH0000X | Hematologist | C168707 | CA |
NPI | 1265745731 |
---|---|
Provider Name | Dr. Sushma Nayak Bharadwaj |
First Address | Palo Alto, CA 94305-2200 |
Second Address | Palo Alto, CA 94305-2200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2010 |
Last Update Date | 01/07/2021 |