Individual
FRANK R BAVUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 MORRIS STREET, SUITE H, SEBASTOPOL, CA 95472
(707) 829-5883
(707) 829-5895
Mailing address
PO BOX 1676, SEBASTOPOL, CA 95473
(707) 829-5883
(707) 829-5895
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
G15463
CA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
G15463
CA
Other
Enumeration date
08/01/2006
Last updated
04/22/2008
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