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General NPI Number Information
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NPI Number | 1225384415
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Entity Type | Individual
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Provider Name | RAFFI A BASHLIAN ANP
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Gender | Male
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 3100 SUMMIT ST 2ND FLOOR, EAST BAY AIDS CENTER (EBAC)
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City | OAKLAND
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State | CA
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Zip | 94609-3412
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Country | US
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Telephone | 510-869-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 584 CASTRO ST STE 3070
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-2512
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Country | US
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Telephone |
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Fax | 404-585-2688
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 306068
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 22379
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License Number State | CA
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