Active NPI
JSK Premier Mso Inc
- Surgery Physician
- Fullerton, CA
National Provider Identifier
1700713195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | |||
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | |||
| Hospice and Palliative Medicine (Psychiatry & Neurology) Physician | 2084H0002X | |||
| Surgery Physician | 208600000X | Primary | ||
| General Practice Physician | 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 DirectoryNPI 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.