Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | A126898 | CA |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | DR0058490 | CO |
Y | 207YP0228X | Pediatric Otolaryngology | A126898 | CA |
N | 207YP0228X | Pediatric Otolaryngology | DR0058490 | CO |
NPI | 1174880496 |
---|---|
Provider Name | Dr. Jay M Bhatt |
First Address | Orange, CA 92868-4306 |
Second Address | Orange, CA 92868-4306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2012 |
Last Update Date | 26/05/2020 |