Bassila, Jean Claude

Bassila, Jean Claude is an individual health care provider with primary practice located at 4720 Hoen Ave Ste 1 , Santa Rosa CA 95405-7867. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Bassila, Jean Claude can be contacted via phone (707) 527-9510.

Contact Information

Primary practice address
4720 Hoen Ave Ste 1 Santa Rosa CA 95405-7867
Phone: (707) 527-9510
Fax: (833) 941-2589
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 22784 Mississippi
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X A145965 California
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 22784 Mississippi
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X A145695 California

Profile Details

NPI number 1487817854
LBN Legal business name Bassila, Jean Claude
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2008
Last updated Apr 20th, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487817854 NPPES
Mississippi MEDICAID 09481295

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