Individual provider · Type 1 NPI
Michael David Bastasch, MD
Specialist · Fremont, CA
NPI number
1912962028
Active
Practice location
39101 Civic Center Dr
Fremont, CA 94538-5817
Fax (510) 745-6469
Mailing address
1801 S Palestine St
Athens, TX 75751-5605
Other practice locations
- 1801 S Palestine St, Athens, TX 75751-5605 · (903) 677-8300
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist | 174400000X | A85084 (CA) |
| Specialist Primary | 174400000X | L9092 (TX) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
2 other providers at this address
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About NPI 1912962028
Michael David Bastasch, MD's National Provider Identifier is 1912962028, issued on Apr 20, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Fremont, CA. The record was last updated on Jun 23, 2021.