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Carlos Bastardo

NPI 1417492281 · on the registry since 2017

Practice

Address
11191 Shadylane Dr
Plymouth, IN 46563
Phone
(574) 936-4152
Fax
(312) 256-9390

Registry record

Primary taxonomy
405300000X
405300000X
Licence states on file
IN
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2017-01-03

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana