Healthcare Provider Details

I. General information

NPI: 1922853050
Provider Name (Legal Business Name): FAHAD BUSKANDAR MB BCH BAO, FRCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2024
Last Update Date: 11/15/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

763 BAY ST LPH4
TORONTO ONTARIO
M5G2R3
CA

IV. Provider business mailing address

763 BAY ST LPH4
TORONTO ONTARIO
M5G2R3
CA

V. Phone/Fax

Practice location:
  • Phone: 416-877-7991
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: