Individual
DR. ISH PRASAD BHALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2101 ROSECRANS AVE # 3230, EL SEGUNDO, CA 90245-4749
(323) 628-8671
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
2018015765
MO
2084P0800X
Psychiatry Physician
2018015765
MO
2084P0800X
Psychiatry Physician
Primary
A154252
CA
Other
Enumeration date
03/27/2013
Last updated
04/02/2020
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