Devaskar, Prakash P

Devaskar, Prakash P is an individual health care provider with primary practice located at 700 River Dr , Fort Bragg CA 95437-5403. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Devaskar, Prakash P can be contacted via phone (707) 961-4631.

Contact Information

Primary practice address
700 River Dr Fort Bragg CA 95437-5403
Phone: (707) 961-4631
Fax: (707) 964-1192
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X CA00A350680 California

Profile Details

NPI number 1912079294
LBN Legal business name Devaskar, Prakash P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2006
Last updated Mar 7th, 2023 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912079294 NPPES
Other 00A350680 CALIFORNIA STATE LIC
MEDICAID 68-0326919 CALIFORNIA STATE LIC

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