MEDICARE: ANITHA BHAT MD

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	207R00000X	Internal Medicine Physician	245349	MA
2	207R00000X	Internal Medicine Physician	A165143	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639480585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITHA BHAT MD

Provider Business Mailing Address
First Line	:	19015 TOWN CENTER DR STE 101
Second Line	:
City	:	APPLE VALLEY
State	:	CA
Zip	:	92308-8943
Country	:	US
Telephone Number	:	760-247-0581
Fax Number	:	760-247-3611

Provider Business Practice Location Address
First Line	:	19015 TOWN CENTER DR STE 101
Second Line	:
City	:	APPLE VALLEY
State	:	CA
Zip	:	92308-8943
Country	:	US
Telephone Number	:	760-247-0581
Fax Number	:	760-247-3611

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

Provider Enumeration Date	:	06/25/2010
Last Update Date	:	10/25/2023

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Directions to “ ANITHA BHAT MD” Practice Location

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