Basic Information
| Provider Information | |||||||||
| NPI: | 1841285277 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BHATTI | ||||||||
| FirstName: | LAVEEZA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8390 CHAMPIONS GATE BLVD | ||||||||
| Address2: | SUITE 215 | ||||||||
| City: | CHAMPIONS GATE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338968310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073901677 | ||||||||
| FaxNumber: | 4073901765 | ||||||||
| Practice Location | |||||||||
| Address1: | 99 NORTH LA CIENEGA BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902112285 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3106579353 | ||||||||
| FaxNumber: | 3106579367 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2005 | ||||||||
| LastUpdateDate: | 06/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | A54090 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207R00000X | A54090 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.