Healthcare Provider Details

I. General information

NPI: 1003692500
Provider Name (Legal Business Name): ISHTLEEN K.BHATIA,M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2023
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4944 SUNRISE BLVD STE H
FAIR OAKS CA
95628-4941
US

IV. Provider business mailing address

4944 SUNRISE BLVD STE H
FAIR OAKS CA
95628-4941
US

V. Phone/Fax

Practice location:
  • Phone: 916-966-8158
  • Fax: 916-966-8118
Mailing address:
  • Phone: 916-966-8158
  • Fax: 916-966-8118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ISHTLEEN BHATIA
Title or Position: PHYSICIAN
Credential: MD
Phone: 916-966-8158