Individual
DR. SATHY VISAKAN BHAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2619 E COLORADO BLVD STE 150, PASADENA, CA 91107-3747
(626) 793-4168
(626) 463-1277
Mailing address
502 E NEW HAVEN AVE, MELBOURNE, FL 32901-5427
(321) 727-2020
(321) 984-9547
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
2004016660
MO
207W00000X
Ophthalmology Physician
Primary
A98352
CA
207W00000X
Ophthalmology Physician
ME124912
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457321903
—
CA
05
—
209368406
—
MO
Enumeration date
01/26/2006
Last updated
07/31/2020
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