Provider Demographics
NPI:1588839500
Name:BHAT, JYOTI (MD)
Entity Type:Individual
Prefix:
First Name:JYOTI
Middle Name:
Last Name:BHAT
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 1:2182 EAST ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2012
Mailing Address - Country:US
Mailing Address - Phone:925-685-4228
Mailing Address - Fax:925-685-6997
Practice Address - Street 1:2182 EAST ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2012
Practice Address - Country:US
Practice Address - Phone:925-685-4228
Practice Address - Fax:925-685-6997
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110293207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism