Basen, Tyler
Basen, Tyler is an individual health care provider with primary practice located at 26691 Plaza Ste 170 , Mission Viejo CA 92691-6396. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Basen, Tyler can be contacted via phone (949) 755-6414.Contact Information
Primary practice address
26691 Plaza Ste 170
Mission Viejo CA 92691-6396
Phone: (949) 755-6414
Fax: (339) 207-0457
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207RA0201X | A141359 | California |
Profile Details
| NPI number | 1184069692 |
|---|---|
| LBN Legal business name | Basen, Tyler |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 10th, 2013 |
| Last updated | Oct 29th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184069692 | NPPES |
| California | MEDICAID | CB299568 |
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