Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Michael David Bastasch, MD

Individual provider Specialist · NPI 1912962028

Michael David Bastasch, MD is a Radiation Oncology in Fremont, California. Graduated from University of Kansas School of Med (KC/WICH/SAL) in 1999, 27 years ago. Practices with Etmc Physician Group, Inc, a 376-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California and Texas.

Years since qualifying
27
Trained at
University of Kansas School of Med (KC/WICH/SAL)
Licensed in
CA, TX
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

39101 Civic Center Dr
Fremont, CA 94538-5817
Phone: (510) 796-7212
Fax: (510) 745-6469
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1801 S Palestine St, Athens, TX 75751-5605 — (903) 677-8300

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence L9092 (TX)
Specialist Taxonomy 174400000X · Licence A85084 (CA)

Record details

NPI number1912962028
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 20, 2006
Last updated in NPPESJune 23, 2021
Certification dateNovember 10, 2020
Mailing address1801 S Palestine St, Athens, TX 75751-5605

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyRADIATION ONCOLOGY
Medical schoolUNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated 1999 (27 years in practice)
Group practice Etmc Physician Group, Inc. — 376 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Fremont