Provider Demographics
NPI:1073158804
Name:BAKHSHI, MALIHEH (NP)
Entity Type:Individual
Prefix:
First Name:MALIHEH
Middle Name:
Last Name:BAKHSHI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HARRIS CT STE A2
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-7823
Mailing Address - Country:US
Mailing Address - Phone:831-800-1593
Mailing Address - Fax:
Practice Address - Street 1:915 HILBY AVE STE 22
Practice Address - Street 2:
Practice Address - City:SEASIDE
Practice Address - State:CA
Practice Address - Zip Code:93955-5359
Practice Address - Country:US
Practice Address - Phone:831-800-1593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013159363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily