Provider Demographics
NPI:1801843743
Name:BIPINCHANDRA V BHAGAT MD INC
Entity Type:Organization
Organization Name:BIPINCHANDRA V BHAGAT MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BIPINCHANDRA
Authorized Official - Middle Name:VENILAL
Authorized Official - Last Name:BHAGAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-951-2400
Mailing Address - Street 1:17290 JASMINE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-7709
Mailing Address - Country:US
Mailing Address - Phone:760-951-2400
Mailing Address - Fax:760-951-3301
Practice Address - Street 1:17290 JASMINE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-7709
Practice Address - Country:US
Practice Address - Phone:760-951-2400
Practice Address - Fax:760-951-3301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA055207207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A552070Medicare PIN
CAG21504Medicare UPIN