Individual
DR. JEFFERSON AUGUSTO BASTIDAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14981 NATIONAL AVE STE 4, LOS GATOS, CA 95032-2600
(408) 358-4747
(408) 358-4742
Mailing address
14981 NATIONAL AVE STE 4, LOS GATOS, CA 95032-2600
(408) 358-4747
(408) 358-4742
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G77498
CA
2086X0206X
Surgical Oncology Physician
G77498
CA
Other
Enumeration date
07/07/2006
Last updated
11/18/2016
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