Active NPI
Bhavani Inc
- Family Medicine Physician
- San Luis Obispo, CA
National Provider Identifier
1093781189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A54017
- Legal business name
- BHAVANI INC
- Practice address
- 1035 Peach Street
Suite 301
San Luis Obispo, CA 93401-2700 - Phone
- (805) 542-0900
- Fax
- (805) 543-9580
- NPI assigned
- Feb 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Donella Jenkins, M.D.
- Title
- Ceo/Cfo
- Phone
- (805) 542-0900
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | |||
| Family Medicine Physician | 207Q00000X | A54017 | CA | Primary |
Addresses
Primary practice location
1035 Peach Street
Suite 301
San Luis Obispo, CA 93401-2700
Mailing address
1035 Peach Street
Suite 301
San Luis Obispo, CA 93401-2700
Phone (805) 542-0900
Other names 1
- Healthworks of the Central Coast
National Provider Directory
National Provider DirectoryLocations
760 Morro Ave
Morro Bay, CA 93442
855 4th St
Ste 1
Pismo Beach, CA 93449
Phone (805) 773-4500
896 E Foothill Blvd
Ste B
San Luis Obispo, CA 93405
Phone (805) 542-0900
1035 Peach St
Ste 30
San Luis Obispo, CA 93401
Phone (805) 542-0900
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- San Luis Obispo, CA
- NPI 1467496091
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140998400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1386633600000",
"number": "1093781189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1035 PEACH STREET",
"address_2": "SUITE 301",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934012700",
"telephone_number": "805-542-0900",
"fax_number": "805-543-9580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1035 PEACH STREET",
"address_2": "SUITE 301",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934012700",
"telephone_number": "805-542-0900",
"fax_number": "805-543-9580"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BHAVANI INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-27",
"last_updated": "2013-12-10",
"status": "A",
"authorized_official_last_name": "JENKINS",
"authorized_official_first_name": "DONELLA",
"authorized_official_title_or_position": "CEO/CFO",
"authorized_official_telephone_number": "805-542-0900",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "CA",
"license": "A54017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Healthworks of the Central Coast",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.