Provider Demographics
NPI:1164951307
Name:BHARMAL, MURTAZA (MD)
Entity type:Individual
Prefix:
First Name:MURTAZA
Middle Name:
Last Name:BHARMAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E VALENCIA MESA DR STE 206
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3817
Mailing Address - Country:US
Mailing Address - Phone:714-449-4800
Mailing Address - Fax:
Practice Address - Street 1:100 E VALENCIA MESA DR STE 206
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3817
Practice Address - Country:US
Practice Address - Phone:714-449-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-10
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA169539208M00000X, 207R00000X
IL125.071084207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine