Individual provider · NPI-1

Dr. Omid Bakhtar, D.O.

Internal Medicine · Watsonville, CA

NPI number1194953901
StatusActive
Last updated in NPPESApr 4, 2019

Details

NPI
1194953901
Entity type
Individual (NPI-1)
Name
Dr. Omid Bakhtar
Credential
D.O.
Sex
Male
Sole proprietor
No
Enumeration date
Jun 30, 2009
Last updated
Apr 4, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine5101018220MIYes

Practice location

65 Neilson St Ste 102
Watsonville, CA 95076-2491

Phone 831-768-6217 · Fax 831-768-6219

Mailing address

3035 Duvall Ct
Gilroy, CA 95020-9165

Phone 517-604-0274

Other practice locations

6071 W Outer Dr
Detroit, MI 48235-2624

Phone 313-966-0515

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