Individual
RYAN BASHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
212 OAK MEADOW DR, LOS GATOS, CA 95032-4407
(408) 354-4740
Mailing address
212 OAK MEADOW DR, LOS GATOS, CA 95032-4407
(408) 354-4740
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
00A121146
CA
207W00000X
Ophthalmology Physician
125054496
IL
Other
Enumeration date
06/30/2008
Last updated
02/16/2015
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