Organization
BHARTI JAIN MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICE DIEFENBACH (BILLING MANAGER)
(909) 425-8460
Entity
Organization
Contact information
Practice address
1800 MEDICAL CENTER DR STE 200, SAN BERNARDINO, CA 92411-1242
(909) 887-3432
Mailing address
1800 MEDICAL CENTER DR STE 200, SAN BERNARDINO, CA 92411-1242
(909) 887-3432
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
C042548
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C425480
—
CA
Enumeration date
04/09/2007
Last updated
08/06/2008
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