Bastasch, Michael David

Bastasch, Michael David is an individual health care provider with primary practice located at 39101 Civic Center Dr , Fremont CA 94538-5817. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Bastasch, Michael David can be contacted via phone (510) 796-7212.

Contact Information

Primary practice address
39101 Civic Center Dr Fremont CA 94538-5817
Fax: (510) 745-6469
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X A85084 California
Other Service Providers / Specialist 174400000X L9092 Texas

Profile Details

NPI number 1912962028
LBN Legal business name Bastasch, Michael David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Jun 23rd, 2021 - about 4 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 1912962028 NPPES
Texas MEDICAID 16796101

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