MEDICARE: FRANKIE DANAE BAHTISHI CSFA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	SA.0003292
2	246ZC0007X	Surgical Assistant	SA.0003292	CO

General Provider Information

NPI Number	:	1639997240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANKIE DANAE BAHTISHI CSFA

Provider Business Mailing Address
First Line	:	2610 GRAND VISTA CIR APT 212
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-5249
Country	:	US
Telephone Number	:	719-460-7294
Fax Number	:

Provider Business Practice Location Address
First Line	:	2610 GRAND VISTA CIR APT 212
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-5249
Country	:	US
Telephone Number	:	719-460-7294
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2024
Last Update Date	:	02/09/2026

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