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Organization

SHYAM BHASKAR, M.D. INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARTHA SEPEDA (PRACTICE ADMINISTRATOR)
(559) 635-7100
Entity
Organization

Contact information

Practice address
22521 AVENIDA EMPRESA, SUITE 107, RANCHO SANTA MARGARITA, CA 92688-2044
(559) 635-7100
(559) 635-7104
Mailing address
231 W NOBLE AVE, VISALIA, CA 93277-2631
(559) 635-7100
(559) 635-7106

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
A74119
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1609063429
CA
Enumeration date
11/19/2014
Last updated
12/02/2014
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