Provider Demographics
NPI:1386844892
Name:ATUL B. VACHHANI, M.D., INC.
Entity Type:Organization
Organization Name:ATUL B. VACHHANI, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ATUL
Authorized Official - Middle Name:B
Authorized Official - Last Name:VACHHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-922-6581
Mailing Address - Street 1:525 E PLAZA DR
Mailing Address - Street 2:307
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-6953
Mailing Address - Country:US
Mailing Address - Phone:805-922-6581
Mailing Address - Fax:805-614-6055
Practice Address - Street 1:525 E PLAZA DR
Practice Address - Street 2:307
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-6953
Practice Address - Country:US
Practice Address - Phone:805-922-6581
Practice Address - Fax:805-614-6055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67917207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A67970Medicaid