Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | A88362 | CA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | A88362 | CA |
NPI | 1386703007 |
---|---|
Provider Name | Chirag Dinesh Bhavsar |
First Address | Riverside, CA 92505-3043 |
Second Address | Riverside, CA 92505-3043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 29/03/2019 |