Provider Demographics
NPI:1588724108
Name:BHATTI, RIZWAN (MD)
Entity type:Individual
Prefix:
First Name:RIZWAN
Middle Name:
Last Name:BHATTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CONGRESS ST
Mailing Address - Street 2:SUITE 502
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3045
Mailing Address - Country:US
Mailing Address - Phone:626-795-2020
Mailing Address - Fax:855-622-8522
Practice Address - Street 1:10 CONGRESS ST
Practice Address - Street 2:SUITE 502
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3045
Practice Address - Country:US
Practice Address - Phone:626-795-2020
Practice Address - Fax:855-622-8522
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA90589207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00Z905890OtherBLUE SHIELD
CAWA90589BMedicare PIN
CAWA90589AMedicare PIN
CAI49444Medicare UPIN
CA00Z905890OtherBLUE SHIELD