Healthcare Provider Details

I. General information

NPI: 1497374680
Provider Name (Legal Business Name): BACHAR BOTRUS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PAUL BTROS MD

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5531 BUSINESS PARK S STE 201A
BAKERSFIELD CA
93309-1683
US

IV. Provider business mailing address

4131 VAHAN CT
LANCASTER CA
93536-6839
US

V. Phone/Fax

Practice location:
  • Phone: 661-371-3170
  • Fax: 661-371-3169
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA207394
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: