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Michael David Bastasch, MD
Specialist in Fremont, California
NPI 1912962028

Michael David Bastasch is a Specialist based in Athens, CA. Michael David Bastasch practices in Fremont, CA and has the professional credentials of MD. The NPI Number for Michael David Bastasch is 1912962028 and holds a License No. A85084 (California).

The current practice location address for Michael David Bastasch is 39101 Civic Center Dr, Fremont, CA and can be reached out via phone at 510-796-7212 and via fax at 510-745-6469. You can also correspond with Michael David Bastasch through the mailing address at 1801 S PALESTINE ST, ATHENS, TX - 75751-5605 (mailing address contact number: 903-677-8300).

Location: 39101 Civic Center Dr, Fremont, CA, 75751-5605
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1912962028
Provider Name
Michael David Bastasch
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
39101 Civic Center Dr, Fremont, CA, 75751-5605
Phone Number
510-796-7212
Fax Number
510-745-6469
Provider Enumeration Date
04/20/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
16796101 05 TX
institution
Provider Business Practice Location Address Details
Address
39101 Civic Center Dr
City
Fremont
State
California
Zip
94538-5817
Phone Number
510-796-7212
Fax Number
510-745-6469
person
Provider Business Mailing Address Details
Address
1801 S Palestine St
City
Athens
State
Texas
Zip
75751-5605
Phone Number
903-677-8300
Fax Number
903-677-8354
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
A85084 (California)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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