Bacharach, Jason
Bacharach, Jason is an individual health care provider with primary practice located at 104 Lynch Creek Way Suite 15, Petaluma CA 94954-2355. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Glaucoma Specialist. Allopathic & Osteopathic Physicians / Glaucoma Specialist is his primary health care specialty. Bacharach, Jason can be contacted via phone (707) 762-3573.Contact Information
Primary practice address
104 Lynch Creek Way Suite 15
Petaluma CA 94954-2355
Phone: (707) 762-3573
Fax: (707) 762-6873
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | G73984 | California |
| Allopathic & Osteopathic Physicians / Glaucoma Specialist | 207WX0009X | G73984 | California |
Profile Details
| NPI number | 1639160112 |
|---|---|
| LBN Legal business name | Bacharach, Jason |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 2nd, 2005 |
| Last updated | Mar 7th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639160112 | NPPES |
| California | Other | 180025762 | PALMETTO GBA |
| California | MEDICAID | G73984 | PALMETTO GBA |
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