Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | P55881 | CA |
NPI | 1154803310 |
---|---|
Provider Name | Shrada Bhattarai |
First Address | San Leandro, CA 94578-2714 |
Second Address | San Leandro, CA 94578-2714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2018 |
Last Update Date | 01/10/2018 |