Bavisetty, Supriya

Bavisetty, Supriya is an individual health care provider with primary practice located at 11333 Sepulveda Blvd , Mission Hills CA 91345-1116. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Bavisetty, Supriya can be contacted via phone (818) 365-9531.

Contact Information

Primary practice address
11333 Sepulveda Blvd Mission Hills CA 91345-1116
Phone: (818) 365-9531
Fax: (818) 898-1682
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A122963 California

Profile Details

NPI number 1134410103
LBN Legal business name Bavisetty, Supriya
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2011
Last updated Sep 29th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134410103 NPPES
California MEDICAID 001229630

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