Bastacky, Samuel Jacob

Bastacky, Samuel Jacob is an individual health care provider with primary practice located at 2200 Ofarrell St , San Francisco CA 94115-3357. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Bastacky, Samuel Jacob can be contacted via phone (415) 833-2000.

Contact Information

Primary practice address
2200 Ofarrell St San Francisco CA 94115-3357
Phone: (415) 833-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X G31957 California

Profile Details

NPI number 1346392156
LBN Legal business name Bastacky, Samuel Jacob
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2007
Last updated Sep 22nd, 2011 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346392156 NPPES
California MEDICAID 00G319570

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