Bastardo, Carlos
Bastardo, Carlos is an individual health care provider with primary practice located at 11191 Shadylane Dr , Plymouth IN 46563-8623. He recently has only one registered license in Other Service Providers / Prevention Professional, which is considered as his primary health care specialty. Bastardo, Carlos can be contacted via phone (574) 936-4152.Contact Information
Primary practice address
11191 Shadylane Dr
Plymouth IN 46563-8623
Phone: (574) 936-4152
Fax: (312) 256-9390
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Prevention Professional | 405300000X | 3577690 | Indiana |
Profile Details
| NPI number | 1417492281 |
|---|---|
| LBN Legal business name | Bastardo, Carlos |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 3rd, 2017 |
| Last updated | Jan 3rd, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417492281 | NPPES |
| Indiana | Other | 3577690 | NATIONAL PRODUCER NUMBER |
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