Provider Demographics
NPI:1932661931
Name:BHAT, PALLAVI (MD)
Entity Type:Individual
Prefix:
First Name:PALLAVI
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 1:39000 BOB HOPE DRIVE
Mailing Address - Street 2:GME OFFICE, ANNENBERG HEALTH SCIENCES BUILDING
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3221
Mailing Address - Country:US
Mailing Address - Phone:760-773-4504
Mailing Address - Fax:760-837-8581
Practice Address - Street 1:4531 BUENA VISTA RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-8794
Practice Address - Country:US
Practice Address - Phone:661-865-5600
Practice Address - Fax:661-865-5601
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8177480207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine