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DR. OMID BAKHTAR D.O.

>> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1194953901

Individual Registrant:
DR. OMID  BAKHTAR D.O.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
65 NEILSON ST STE 102  WATSONVILLE, CA 95076-2491 US
Tel: 831-768-6217  Fax: 831-768-6219

Contact information for business:
3035 DUVALL CT  GILROY, CA 95020-9165 US
Tel: 517-604-0274  Fax: --

Registration Information:
NPI: 1194953901
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
MI5101018220

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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