Healthcare Provider Details

I. General information

NPI: 1770961575
Provider Name (Legal Business Name): ABINAV BAWEJA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2015
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 W LAS POSITAS BLVD
PLEASANTON CA
94588-4000
US

IV. Provider business mailing address

5555 W LAS POSITAS BLVD
PLEASANTON CA
94588-4000
US

V. Phone/Fax

Practice location:
  • Phone: 925-416-5470
  • Fax:
Mailing address:
  • Phone: 925-416-5470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberA154829
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberA154829
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA154829
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA154829
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: