Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | C50673 | CA |
NPI | 1023107794 |
---|---|
Provider Name | Virinder Kumar Bhardwaj |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Porterville, CA 93257 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 28/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B49059 | (02) |