Individual
GAVIN BAHADUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1807 WILSHIRE BLVD, SUITE 203, SANTA MONICA, CA 90403-5652
(310) 829-0160
(310) 829-0170
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5655
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G83596
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G835960
—
CA
Enumeration date
07/04/2006
Last updated
01/22/2020
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