Healthcare Provider Details

I. General information

NPI: 1467324590
Provider Name (Legal Business Name): PHILIP B BHASKAR DMD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

337 EL DORADO ST STE A1
MONTEREY CA
93940-4638
US

IV. Provider business mailing address

337 EL DORADO ST STE A1
MONTEREY CA
93940-4638
US

V. Phone/Fax

Practice location:
  • Phone: 831-372-2882
  • Fax:
Mailing address:
  • Phone: 831-372-2882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: PHILIP BRIAN BHASKAR
Title or Position: PRESIDENT
Credential: DMD
Phone: 831-372-2882