Provider Demographics
NPI:1851981799
Name:BASH PHYSIATRY INC
Entity Type:Organization
Organization Name:BASH PHYSIATRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BASHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-689-5718
Mailing Address - Street 1:3905 STATE ST STE 7-132
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3138
Mailing Address - Country:US
Mailing Address - Phone:805-689-5718
Mailing Address - Fax:
Practice Address - Street 1:2415 DE LA VINA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3819
Practice Address - Country:US
Practice Address - Phone:805-687-7444
Practice Address - Fax:805-687-3707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty