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NPI Code Detail

MEDICARE: DR. KEYVAN BAHADI MD

MEDICARE: DR. KEYVAN BAHADI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery PhysicianA31245CA

General Provider Information

NPI Number : 1376595314
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEYVAN BAHADI MD
Provider Business Mailing Address
First Line : 1484 POLLARD RD
Second Line : PMB 305
City : LOS GATOS
State : CA
Zip : 95032-1031
Country : US
Telephone Number : 408-358-8665
Fax Number : 408-358-8605
Provider Business Practice Location Address
First Line : 2425 SAMARITAN DR
Second Line :
City : SAN JOSE
State : CA
Zip : 95124-3908
Country : US
Telephone Number : 408-559-2011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 08/28/2024

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Directions to “ DR. KEYVAN BAHADI MD” Practice Location

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