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Contact Information

MARK BASTA, OD
1237 B ST.
HAYWARD, CA94541
 Phone: 510-593-4876
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for MARK BASTA · (Male)

NPI Number 1679073803
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 02/14/2018
Last updated 02/14/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # OPT7412-TLG
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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