Healthcare Provider Details

I. General information

NPI: 1902977366
Provider Name (Legal Business Name): SAMIR N BHATT M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 E MAIN ST STE 101
SANTA MARIA CA
93454-4826
US

IV. Provider business mailing address

1510 E MAIN ST STE 101
SANTA MARIA CA
93454-4826
US

V. Phone/Fax

Practice location:
  • Phone: 805-928-0610
  • Fax: 805-928-0680
Mailing address:
  • Phone: 805-928-0610
  • Fax: 805-928-0680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG70837
License Number StateCA

VIII. Authorized Official

Name: SAMIR N. BHATT
Title or Position: PRESIDENT
Credential: M.D, F.A.C.C.
Phone: 805-928-0610