Organization
MAHESH BHUTA MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAHESH BHUTA MD (RESIDENT/OWNER)
(310) 559-9884
Entity
Organization
Contact information
Practice address
9711 VENICE BLVD, LOS ANGELES, CA 90034-5109
(310) 559-9884
Mailing address
9711 VENICE BLVD, LOS ANGELES, CA 90034-5109
(310) 559-9884
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
A29467
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A29467
LICENSE NUMBER - A29467
CA
Enumeration date
05/11/2015
Last updated
05/11/2015
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