Healthcare Provider Details

I. General information

NPI: 1780751735
Provider Name (Legal Business Name): JASWANT KHOKHAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 TRUXTUN AVE SUITE #160
BAKERSFIELD CA
93309-0679
US

IV. Provider business mailing address

6001 TRUXTUN AVE SUITE #160
BAKERSFIELD CA
93309-0679
US

V. Phone/Fax

Practice location:
  • Phone: 661-323-6410
  • Fax: 661-323-0634
Mailing address:
  • Phone: 661-323-6410
  • Fax: 661-323-0634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA50719
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA50719
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberA93179
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: