Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 15481 | MO |
NPI | 1891906079 |
---|---|
Provider Name | Dr. Trent Ray Bachman |
First Address | Pleasanton, CA 94566-6825 |
Second Address | Pleasanton, CA 94566-6825 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2007 |
Last Update Date | 08/07/2007 |