Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A26233 | CA |
Y | 208600000X | Surgeon | A26233 | CA |
NPI | 1003948035 |
---|---|
Provider Name | Bakthan Savarirayan |
First Address | Anaheim, CA 92804-3702 |
Second Address | Anaheim, CA 92804-3702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A87014,A25816 | (02) | |
A87014,A25816 | (02) | CA |
ZZZ762832 | (05) | CA |