NPI Code Detail JSON Logo

1730310830 NPI number — NIRMAL BASTOLA MD

NPI Number: 1730310830
Health Care Provider/Practitioner: NIRMAL BASTOLA MD

Information about “1730310830” NPI (NIRMAL BASTOLA MD) exists in 1730310830 in HTML format HTML  |  1730310830 in plain Text format TXT  |  1730310830 in PDF (Portable Document Format) PDF  |  1730310830 in an XML format XML  formats.

NPI Number : 1730310830 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1730310830",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BASTOLA",
    "FirstName": "NIRMAL",
    "MiddleName": null,
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2020 CAPITOL ST NE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SALEM",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97301-0644",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "503-399-2424",
    "MailingAddressFaxNumber": "503-375-7429",
    "FirstLinePracticeLocationAddress": "5900 INLAND SHORES WAY N",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "KEIZER",
    "PracticeLocationAddressStateName": "OR",
    "PracticeLocationAddressPostalCode": "97303-3883",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "503-399-2424",
    "PracticeLocationAddressFaxNumber": "503-589-6240",
    "EnumerationDate": "08/06/2009",
    "LastUpdateDate": "06/07/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "6135",
          "LicenseNumberStateCode": "NE",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "MD181082",
          "LicenseNumberStateCode": "OR",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.