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General NPI Number Information
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NPI Number | 1003833948
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Entity Type | Individual
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Provider Name | JYOTI MANOHAR BAKHRU M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 3460 KATELLA AVE
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-2334
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Country | US
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Telephone | 562-594-6599
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Fax | 562-598-6220
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Provider Business Mailing Address
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Address Line | PO BOX 35380
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City | LAS VEGAS
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State | NV
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Zip | 89133-5380
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0000X
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Taxonomy Name | Adolescent Medicine (Internal Medicine) Physician
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License Number | A44963
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License Number State | CA
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