Organization
GAVIN G. BAHADUR, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAVIN G. BAHADUR M.D. (PRESIDENT)
(310) 403-5251
Entity
Organization
Contact information
Practice address
1807 WILSHIRE BLVD, SUITE 203, SANTA MONICA, CA 90403-5652
(310) 829-0160
(310) 829-0170
Mailing address
2444 WILSHIRE BLVD, SUITE 504, SANTA MONICA, CA 90403-5808
(310) 453-4965
(310) 453-5670
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
10/27/2010
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