Sushma Bahl MD, Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A45671 Issued in CA

Legal business name

SUSHMA BAHL MD, INC.

Practice address

16300 Sand Canyon Ave
Suite 708
Irvine, CA 92618-3711

Phone

(714) 262-9143

Fax

(866) 874-1139

NPI assigned

May 4, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dianna Thorbjornsen

Title

Office Manager

Phone

(909) 396-0309

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304467200000",
    "number": "1508158957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23437 GOLDEN SPRINGS DR",
            "address_2": "SUITE 114",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917652030",
            "telephone_number": "909-396-0309",
            "fax_number": "866-874-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16300 SAND CANYON AVE",
            "address_2": "SUITE 708",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183711",
            "telephone_number": "714-262-9143",
            "fax_number": "866-874-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSHMA BAHL MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-04",
        "last_updated": "2011-05-04",
        "status": "A",
        "authorized_official_last_name": "THORBJORNSEN",
        "authorized_official_first_name": "DIANNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "909-396-0309"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A45671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Irvine, CA
• Providers in Irvine, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.