Healthcare Provider Details

I. General information

NPI: 1447281704
Provider Name (Legal Business Name): RAJ BHATIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 11/24/2020
Certification Date: 11/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 OUTLET CENTER DR
OXNARD CA
93036
US

IV. Provider business mailing address

1910 OUTLET CENTER DR
OXNARD CA
93036
US

V. Phone/Fax

Practice location:
  • Phone: 805-485-2400
  • Fax: 805-485-3025
Mailing address:
  • Phone: 805-485-2400
  • Fax: 805-485-2455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA61991
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA61991
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberA61991
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: