Provider Demographics
NPI:1013002328
Name:BHATIA, PERMINDER (MD)
Entity Type:Individual
Prefix:DR
First Name:PERMINDER
Middle Name:
Last Name:BHATIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 E BULLARD AVE
Mailing Address - Street 2:#101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710
Mailing Address - Country:US
Mailing Address - Phone:559-437-9700
Mailing Address - Fax:559-437-9799
Practice Address - Street 1:736 E BULLARD AVE
Practice Address - Street 2:#101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710
Practice Address - Country:US
Practice Address - Phone:559-437-9700
Practice Address - Fax:559-437-9799
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA617972084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A617970Medicaid
CAA61797OtherCALIFORNIA LICENSE
CA00A61797Medicare ID - Type Unspecified
CA130025556Medicare PIN
CAA61797OtherCALIFORNIA LICENSE