Individual
DR. ASHISH ASHOK BHAVSAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1310 W STEWART DR, STE 410, ORANGE, CA 92868-3854
(714) 639-9401
(714) 639-4105
Mailing address
1310 W STEWART DR, STE 410, ORANGE, CA 92868-3854
(714) 639-9401
(714) 639-4105
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A117360
CA
208M00000X
Hospitalist Physician
Primary
A117360
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912919804
TYPE 2 NPI
CA
01
—
A117360
MEDICAL LICENSE NUMBER
CA
01
—
CG5665
RAIL ROAD MEDICARE GROUP PTAN
CA
01
—
P01292528
RAIL ROAD MEDICARE PROVIDER PTAN
CA
Enumeration date
01/23/2008
Last updated
05/13/2014
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