Provider Demographics
NPI:1073854915
Name:BITA MEDICAL, INC.
Entity Type:Organization
Organization Name:BITA MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BADAKHSHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-680-1880
Mailing Address - Street 1:6 HUGHES
Mailing Address - Street 2:SUITE 100
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2059
Mailing Address - Country:US
Mailing Address - Phone:949-680-1880
Mailing Address - Fax:949-680-1919
Practice Address - Street 1:6 HUGHES
Practice Address - Street 2:SUITE 100
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2059
Practice Address - Country:US
Practice Address - Phone:949-680-1880
Practice Address - Fax:949-680-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA116789207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty