| Shyam Bhaskar, M.d. Inc | |
|
22521 Avenida Empresa Suite 107 Rancho Santa Margarita CA 92688-2044 | |
| (559) 635-7100 | |
| (559) 635-7104 |
| Full Name | Shyam Bhaskar, M.d. Inc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 22521 Avenida Empresa, Rancho Santa Margarita, California |
| Authorized Official Name and Position | Martha Sepeda (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 5596357100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shyam Bhaskar, M.d. Inc 231 W Noble Ave Visalia CA 93277-2631 Ph: (559) 635-7100 | Shyam Bhaskar, M.d. Inc 22521 Avenida Empresa Suite 107 Rancho Santa Margarita CA 92688-2044 Ph: (559) 635-7100 |
| NPI Number | 1598162562 |
|---|---|
| Provider Enumeration Date | 11/19/2014 |
| Last Update Date | 12/02/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598162562 | NPI | - | NPPES |
| 1609063429 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | A74119 (California) | Primary |
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