Organization Active NPI

JSK Premier Mso Inc

  • Surgery Physician
  • Fullerton, CA
National Provider Identifier
1700713195
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
JSK PREMIER MSO INC
Practice address
2720 N Harbor Blvd Ste 350
Fullerton, CA 92835-2602
Phone
(714) 529-8923
NPI assigned
May 7, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ashish Bhavsar, MD
Title
Ceo
Phone
(909) 631-8521

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Hospice and Palliative Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084H0002X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

2720 N Harbor Blvd Ste 350
Fullerton, CA 92835-2602

Mailing address

17 Barlett PL
Tustin, CA 92782-3742
Phone (909) 631-8521

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1778112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778112000000",
    "number": "1700713195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 BARLETT PL",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927823742",
            "telephone_number": "909-631-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 N HARBOR BLVD STE 350",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352602",
            "telephone_number": "714-529-8923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JSK PREMIER MSO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-07",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A",
        "authorized_official_last_name": "BHAVSAR",
        "authorized_official_first_name": "ASHISH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-631-8521",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084H0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.