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General NPI Number Information
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NPI Number | 1750701926
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Entity Type | Individual
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Provider Name | PAAYAL BHAKTA
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Gender | Female
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Dates
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Enumeration Date | 04/25/2014
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Last Update Date | 01/17/2019
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Provider Practice Location Address
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Address Line | 5650 JILLSON ST
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City | COMMERCE
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State | CA
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Zip | 90040-1482
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Country | US
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Telephone | 323-201-4516
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Fax |
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Provider Business Mailing Address
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Address Line | 5650 JILLSON ST
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City | COMMERCE
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State | CA
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Zip | 90040-1482
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Country | US
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Telephone | 323-201-4516
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A149562
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License Number State | CA
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