MEDICARE: MS. PRITI JITEN BHATT MPT, NDTC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	25378	CA

General Provider Information

NPI Number	:	1013111087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PRITI JITEN BHATT MPT, NDTC

Provider Business Mailing Address
First Line	:	4623 JESSICA DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90065-4151
Country	:	US
Telephone Number	:	323-255-5576
Fax Number	:

Provider Business Practice Location Address
First Line	:	4623 JESSICA DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90065-4151
Country	:	US
Telephone Number	:	323-255-5576
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2007
Last Update Date	:	12/01/2021

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