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NPI Code Detail

MEDICARE: JYOTHI BACHWANI M.D.

MEDICARE: JYOTHI BACHWANI M.D.
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
1207R00000XInternal Medicine Physician229847MA

General Provider Information

NPI Number : 1659489979
Entity Type Code : Individual
Provider Name (Legal Business Name) : JYOTHI BACHWANI M.D.
Provider Business Mailing Address
First Line : 5237 GENOVESIO DR
Second Line :
City : PLEASANTON
State : CA
Zip : 94588-6007
Country : US
Telephone Number : 781-266-8913
Fax Number :
Provider Business Practice Location Address
First Line : 12 CAMINO ENCINAS
Second Line : 2'ND FLOOR
City : ORINDA
State : CA
Zip : 94563-3304
Country : US
Telephone Number : 510-204-8189
Fax Number : 925-254-8488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2006
Last Update Date : 03/30/2010

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