Sanjay K Bakshi, BSC
Individual provider Active NPI Driver · Hercules, CA
NPI 1619790722 · NPPES record last updated Nov 6, 2024
Key facts
- NPI
- 1619790722
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- A7447070 (CA)
- Practice address
- 133 Falcon Way
Hercules, CA 94547-1505 - Phone
- (510) 672-3648
- NPI assigned
- Nov 6, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A7447070 | CA | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | A7447070 | CA | Yes |
Addresses
Primary practice location
133 Falcon Way
Hercules, CA 94547-1505
Mailing address
133 Falcon Way
Hercules, CA 94547-1505
Phone (510) 672-3648
Other practice location 1
133 Falcon Way
Hercules, CA 94547-1505
Phone (510) 672-3648
Other providers in Hercules, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.