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General NPI Number Information
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NPI Number | 1689797284
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Entity Type | Organization
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Legal Business Name | BHARTI JAIN MD INC
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 08/06/2008
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Provider Practice Location Address
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Address Line | 1800 MEDICAL CENTER DR STE 200
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City | SAN BERNARDINO
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State | CA
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Zip | 92411-1242
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Country | US
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Telephone | 909-887-3432
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 MEDICAL CENTER DR STE 200
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City | SAN BERNARDINO
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State | CA
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Zip | 92411-1242
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Country | US
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Telephone | 909-887-3432
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | PATRICE DIEFENBACH
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Credential |
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Telephone | 909-425-8460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | C042548
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License Number State | CA
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