MEDICARE: JASJOT K. BHULLAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	C194882	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8598	OTHER	SC	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366602229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASJOT K. BHULLAR M.D.

Provider Business Mailing Address
First Line	:	1362 PAIGE LN
Second Line	:
City	:	REDLANDS
State	:	CA
Zip	:	92373-6845
Country	:	US
Telephone Number	:	207-689-7007
Fax Number	:

Provider Business Practice Location Address
First Line	:	11234 ANDERSON ST
Second Line	:
City	:	LOMA LINDA
State	:	CA
Zip	:	92354-2804
Country	:	US
Telephone Number	:	909-580-4000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2008
Last Update Date	:	04/21/2026

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