Healthcare Provider Details

I. General information

NPI: 1912270042
Provider Name (Legal Business Name): WILLIAM CARLOS BHASKAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2012
Last Update Date: 02/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 EL DORADO ST SUITE 3
MONTEREY CA
93940-4625
US

IV. Provider business mailing address

335 EL DORADO ST SUITE 3
MONTEREY CA
93940-4625
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberF6439
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: