Provider Demographics
NPI:1730869702
Name:AJAY BHATNAGAR MD PC
Entity type:Organization
Organization Name:AJAY BHATNAGAR MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATNAGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-360-4009
Mailing Address - Street 1:1445 W CHANDLER BLVD STE A5
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6130
Mailing Address - Country:US
Mailing Address - Phone:714-912-0020
Mailing Address - Fax:714-912-0021
Practice Address - Street 1:11100 WARNER AVE STE 206
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7511
Practice Address - Country:US
Practice Address - Phone:714-912-0020
Practice Address - Fax:714-912-0021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty