MEDICARE: DR. BITA BEHJATNIA 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	A79031	CA

General Provider Information

NPI Number	:	1396909966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BITA BEHJATNIA M.D.

Provider Business Mailing Address
First Line	:	3405 E HAMMOND CIR
Second Line	:	UNIT # F
City	:	ORANGE
State	:	CA
Zip	:	92869-7509
Country	:	US
Telephone Number	:	714-633-7716
Fax Number	:

Provider Business Practice Location Address
First Line	:	3405 E HAMMOND CIR
Second Line	:	UNIT # F
City	:	ORANGE
State	:	CA
Zip	:	92869-7509
Country	:	US
Telephone Number	:	714-633-7716
Fax Number	:

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

Provider Enumeration Date	:	07/14/2008
Last Update Date	:	07/14/2008

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