Organization
SHYAM BHASKAR, M.D. INC
Active
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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