Individual
NIKETH BANDLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2330 UTAH AVE STE 200, EL SEGUNDO, CA 90245-4817
(281) 766-0959
Mailing address
110 IRVING ST NW, DEPARTMENT OF SURGERY, WASHINGTON, DC 20010-3017
(202) 877-3536
(202) 877-3699
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
4301507188
MI
2085R0202X
Diagnostic Radiology Physician
Primary
ME163854
FL
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
03/30/2017
Last updated
01/09/2025
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