Provider Demographics
NPI:1235380080
Name:BATRA, ASHWANI (NP)
Entity Type:Individual
Prefix:MR
First Name:ASHWANI
Middle Name:
Last Name:BATRA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 903173
Mailing Address - Street 2:2220 E PALMDALE BLVD
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-4980
Mailing Address - Country:US
Mailing Address - Phone:661-310-3388
Mailing Address - Fax:
Practice Address - Street 1:38345 30TH ST E STE B1A
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-6508
Practice Address - Country:US
Practice Address - Phone:661-310-3388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20139261QU0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8915189OtherMEDICARE PTAN
WAG8915188OtherGROUP PTAN
WAG8915189OtherMEDICARE PTAN