Individual
PRAKRITI BISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20103 LAKE CHABOT RD, CASTRO VALLEY, CA 94546-5305
(510) 727-3256
(510) 727-3107
Mailing address
7370 N PALM AVE, FRESNO, CA 93711-5782
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
139923
CA
208M00000X
Hospitalist Physician
Primary
139923
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/24/2013
Last updated
03/01/2022
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