JASON BACHARACH (NPI# 1639160112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639160112 |
| Entity Type | Individual |
| Full Name | JASON BACHARACH |
| Credential | MD |
| Practice Address |
104 Lynch Creek Way Suite 15 Petaluma CA 94954-2355 |
| Practice Telephone | 7077623573 |
| Practice Fax Number | 7077626873 |
| Mailing Telephone | 7077623573 |
| Mailing Fax Number | 7077626873 |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2019-01-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | G73984 | CA | Allopathic & Osteopathic Physicians |
| Y | 207WX0009X |
Ophthalmology Specialization: Glaucoma Specialist |
G73984 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | G73984 | 05 | |
| CA | DEA | BB2698996 | 01 |
| CA | PALMETTO GBA | 180025762 | 01 |
| Street Address |
104 LYNCH CREEK WAY SUITE 15 |
| City | PETALUMA |
| State | CA |
| Zip Code | 94954-2355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972751915 | Saw Wynn Aye | Internal Medicine | 104 Lynch Creek Way, Ste 10, Petaluma, CA 94954-2355 | 2008-09-03 |
| 1073769055 | Jessica Flinders | Nurse Practitioner | 104 Lynch Creek Way, Suite 10, Petaluma, CA 94954-2355 | 2008-08-11 |
| 1538344742 | North Bay Eye Associates, A Medical Corporation | Durable Medical Equipment & Medical Supplies | 104 Lynch Creek Way, Suite 15, Petaluma, CA 94954-2355 | 2008-01-07 |
| 1245411529 | Northern California Medical Assoc Inc | Internal Medicine | 104 Lynch Creek Way, Ste 10, Petaluma, CA 94954-2355 | 2007-11-15 |
| 1346453297 | Loree Ann Skidmore | Nurse Practitioner | 104 Lynch Creek Way, Suite 10, Petaluma, CA 94954-2355 | 2007-05-08 |
| 1205936861 | James Francis Leoni | Family Medicine | 104 Lynch Creek Way, Ste 10, Petaluma, CA 94954-2355 | 2006-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346883840 | Miguel Ibarra | Counselor | 5350 Old Redwood Highway, Petaluma, CA 94954 | 2019-10-28 |
| 1073169223 | Monica Renee Najera | Behavior Technician | 1670 Corporate Circle, Ste. 100, Petaluma, CA 94954 | 2019-08-14 |
| 1326607201 | Making Magic Happen - People Helping People, Inc. | Marriage & Family Therapist | 1318 Redwood Way, Suite 260, Petaluma, CA 94954 | 2019-06-13 |
| 1477019917 | Rubi Isela Cruz Mendoza I | Behavioral Analyst | 8 Round Walk Circle, Petaluma, CA 94954 | 2019-02-20 |
| 1932679511 | Karen Christianson | Behavior Technician | 1670 Corporate Circle Suite 100, Petaluma, CA 94954 | 2018-11-27 |
| 1669956967 | Alyssa Messer | Assistant Behavior Analyst | 1670 Corporate Cir, Petaluma, CA 94954 | 2018-09-21 |
| 1235620592 | Mallory Paige Mullikin | Nurse Practitioner | 141 Lynch Creek Trail, Ste C, Petaluma, CA 94954 | 2018-05-22 |
| 1457723710 | Lisabel Dolne | Counselor | 1360 N. Mcdowell Blvd.1a, Petaluma, CA 94954 | 2015-10-27 |
| 1083080717 | Pacific Restorative Center | Clinic/Center | 1456 Professional Drive, Suite 404, Petaluma, CA 94954 | 2015-08-17 |
| 1619354198 | Accu Quest Hearing Centers | Clinic/Center | 1456 Professional Dr., Suite 404, Petaluma, CA 94954 | 2015-05-04 |
| Find all providers in zip 94954 | ||||
| Taxonomy Code | 207WX0009X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Glaucoma Specialist |
| An ophthalmologist who specializes in the treatment of glaucoma and other disorders related to increased intraocular pressure and optic nerve damage. This specialty involves the medical and surgical treatment of these conditions. |
| Notes: Source: American Academy of Ophthalmology, www.aao.org [1/1/2017: new] Additional Resources: Association of University Professors of Ophthalmology, www.aupo.org |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457967804 | Nirmala Vision PC | Ophthalmology | 801 N Tustin Ave Ste 700, Santa Ana, CA 92705-3611 | 2020-09-21 |
| 1942840558 | Michael Marchand-gareau | Ophthalmology | Michael Marchand - Uc Davis Eye Center, 4860 Y Street, Suite 2400, Sacramento, CA 95817 | 2020-01-11 |
| 1336704410 | Elham Ghahari | Ophthalmology | 9415 Campus Point Dr Rm 179, La Jolla, CA 92093-1350 | 2019-05-05 |
| 1740433945 | Jacob Wellington Brubaker | Ophthalmology | 1515 River Park Dr Ste 100, Sacramento, CA 95815-4605 | 2008-10-31 |
| 1508478850 | Vision Specialists of California, LLC | Ophthalmology | 233 Lewis St, San Diego, CA 92103-2122 | 2020-08-18 |
| 1427443316 | Eric H Chan | Ophthalmology | 9415 Campus Point Dr, La Jolla, CA 92093 | 2015-03-30 |
| 1760821375 | Han Kim | Ophthalmology | 4860 Y St Ste 2400, Sacramento, CA 95817-2307 | 2013-06-17 |
| 1760828248 | Billy Xiaoyi Pan | Ophthalmology | 416 N Bedford Dr Ste 300, Beverly Hills, CA 90210-4309 | 2013-05-10 |
| 1326300377 | Andrew Camp | Ophthalmology | 9415 Campus Point Drive, San Diego, CA 92134-1098 | 2012-06-14 |
| 1891002044 | Cristiana Vasile | Ophthalmology | 200 W Arbor Dr, San Diego, CA 92103-9001 | 2010-09-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.