Individual
HERNAN ANTONIO BAZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 VAN NESS AVE FL 5, SAN FRANCISCO, CA 94109-6978
(415) 537-8600
Mailing address
PO BOX 276950, SACRAMENTO, CA 95827-6950
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
044485
CT
2086S0129X
Vascular Surgery Physician
201525
LA
2086S0129X
Vascular Surgery Physician
Primary
C203948
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01078003
—
MS
01
—
044485
LICENSE
CT
05
—
1014630
—
LA
Enumeration date
05/31/2007
Last updated
11/06/2025
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