Provider Demographics
NPI:1356904015
Name:BHASKAR, RAHUL DAVE (MD)
Entity type:Individual
Prefix:
First Name:RAHUL
Middle Name:DAVE
Last Name:BHASKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-229 WAIPAHU DEPOT ST STE 101
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3032
Mailing Address - Country:US
Mailing Address - Phone:808-206-9849
Mailing Address - Fax:808-206-9850
Practice Address - Street 1:94-229 WAIPAHU DEPOT ST STE 101
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3032
Practice Address - Country:US
Practice Address - Phone:808-206-9849
Practice Address - Fax:808-206-9850
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL.0007885207R00000X
HIMD-24381207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine