Individual
DR. BASHAR KHANDAKER AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1221 FARMERS LN STE 500, SANTA ROSA, CA 95405-6712
(707) 308-3105
(707) 546-4062
Mailing address
1221 FARMERS LN STE 500, SANTA ROSA, CA 95405-6712
(707) 308-3105
(707) 546-4062
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
58125
AZ
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A152947
CA
Other
Enumeration date
06/26/2014
Last updated
12/10/2020
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