Organization
JSK PREMIER MSO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHISH BHAVSAR MD (CEO)
(909) 631-8521
Entity
Organization
Contact information
Practice address
2720 N HARBOR BLVD STE 350, FULLERTON, CA 92835-2602
(714) 529-8923
Mailing address
17 BARLETT PL, TUSTIN, CA 92782-3742
(909) 631-8521
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
2084H0002X
Hospice and Palliative Medicine (Psychiatry & Neurology) Physician
—
—
208600000X
Surgery Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
05/07/2026
Last updated
05/07/2026
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