Provider Demographics
NPI:1407082688
Name:BAHIA &BAL PS
Entity Type:Organization
Organization Name:BAHIA &BAL PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMRINDER
Authorized Official - Middle Name:PS
Authorized Official - Last Name:BAHIA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:253-383-2300
Mailing Address - Street 1:1019 DIVISION AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-1633
Mailing Address - Country:US
Mailing Address - Phone:253-383-2300
Mailing Address - Fax:
Practice Address - Street 1:1019 DIVISION AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-1633
Practice Address - Country:US
Practice Address - Phone:253-383-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA10996261QD0000X
WA9290261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental