Provider Demographics
NPI:1003173931
Name:BHARDWAJ, DEEPAK KUMAR (CERTIFIED ORTHOTIST)
Entity type:Individual
Prefix:MR
First Name:DEEPAK
Middle Name:KUMAR
Last Name:BHARDWAJ
Suffix:
Gender:M
Credentials:CERTIFIED ORTHOTIST
Other - Prefix:
Other - First Name:DEEPAK
Other - Middle Name:
Other - Last Name:KUMAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7121 WOODLEY AVE APT 206
Mailing Address - Street 2:STE 215
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-3975
Mailing Address - Country:US
Mailing Address - Phone:888-552-6188
Mailing Address - Fax:747-254-4155
Practice Address - Street 1:18401 BURBANK BLVD STE 215
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6611
Practice Address - Country:US
Practice Address - Phone:888-552-6188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-17
Last Update Date:2025-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier