Provider Demographics
NPI:1780751735
Name:KHOKHAR, JASWANT (MD)
Entity type:Individual
Prefix:DR
First Name:JASWANT
Middle Name:
Last Name:KHOKHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 TRUXTUN AVE
Mailing Address - Street 2:SUITE #160
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0679
Mailing Address - Country:US
Mailing Address - Phone:661-323-6410
Mailing Address - Fax:661-323-0634
Practice Address - Street 1:6001 TRUXTUN AVE
Practice Address - Street 2:SUITE #160
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0679
Practice Address - Country:US
Practice Address - Phone:661-323-6410
Practice Address - Fax:661-323-0634
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA507192084P0800X, 2084P0804X
CAA931792084B0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A507190Medicare ID - Type Unspecified
CAF41053Medicare UPIN