Provider Demographics
NPI:1699268516
Name:THAPA, PRABAL BICKRAM
Entity type:Individual
Prefix:
First Name:PRABAL
Middle Name:BICKRAM
Last Name:THAPA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 GIUFFRIDA AVE APT C
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-1534
Mailing Address - Country:US
Mailing Address - Phone:408-802-4554
Mailing Address - Fax:
Practice Address - Street 1:1671 THE ALAMEDA STE 306
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2222
Practice Address - Country:US
Practice Address - Phone:669-455-0585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-14
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist