Provider Demographics
NPI:1073848123
Name:BHUTRA, JONI ARTI (MD)
Entity Type:Individual
Prefix:
First Name:JONI
Middle Name:ARTI
Last Name:BHUTRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24515 KANSAS ST
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-1719
Mailing Address - Country:US
Mailing Address - Phone:661-253-4971
Mailing Address - Fax:
Practice Address - Street 1:24515 KANSAS ST
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-1719
Practice Address - Country:US
Practice Address - Phone:661-253-4971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-07
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA107601208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics