Provider Demographics
NPI:1174785265
Name:ARTHUR BASHAM MD
Entity type:Organization
Organization Name:ARTHUR BASHAM MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:BASHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-354-4740
Mailing Address - Street 1:212 OAK MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-4407
Mailing Address - Country:US
Mailing Address - Phone:408-354-4740
Mailing Address - Fax:408-354-8161
Practice Address - Street 1:212 OAK MEADOW DR
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-4407
Practice Address - Country:US
Practice Address - Phone:408-354-4740
Practice Address - Fax:408-354-8161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG39527207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G395270Medicare PIN