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NPI Code Detail

MEDICARE: J S BISLA LLC

MEDICARE: J S BISLA LLC
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
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1528214046
Entity Type Code : Organization
Provider Name (Legal Business Name) : J S BISLA LLC
Provider Business Mailing Address
First Line : 6677 W THUNDERBIRD RD STE I164
Second Line :
City : GLENDALE
State : AZ
Zip : 85306-3762
Country : US
Telephone Number : 623-878-2100
Fax Number : 623-776-9419
Provider Business Practice Location Address
First Line : 6677 W THUNDERBIRD RD STE I164
Second Line :
City : GLENDALE
State : AZ
Zip : 85306-3762
Country : US
Telephone Number : 623-878-2100
Fax Number : 623-776-9419
Authorized Official
Title or Position : OWNER
Name : JASBIR BISLA
Credential : MD
Telephone Number : 623-876-1634
Provider Enumeration Date : 08/15/2008
Last Update Date : 04/03/2025

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