=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902977366
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAMIR N BHATT M D INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/10/2006
-----------------------------------------------------
Last Update Date | 09/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1510 E MAIN ST STE 101
-----------------------------------------------------
City | SANTA MARIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93454-4826
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-928-0610
-----------------------------------------------------
Fax | 805-928-0680
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1510 E MAIN ST STE 101
-----------------------------------------------------
City | SANTA MARIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93454-4826
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-928-0610
-----------------------------------------------------
Fax | 805-928-0680
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | SAMIR N. BHATT
-----------------------------------------------------
Credential | M.D, F.A.C.C.
-----------------------------------------------------
Telephone | 805-928-0610
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | G70837
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------