Basta, Fawzy Samy
Basta, Fawzy Samy is an individual health care provider with primary practice located at 17075 Devonshire St Ste 204, Northridge CA 91325-5408. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Basta, Fawzy Samy can be contacted via phone (818) 368-8929.Contact Information
Primary practice address
17075 Devonshire St Ste 204
Northridge CA 91325-5408
Phone: (818) 368-8929
Fax: (818) 368-8940
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | A42961 | California |
Profile Details
| NPI number | 1043394505 |
|---|---|
| LBN Legal business name | Basta, Fawzy Samy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 24th, 2006 |
| Last updated | Jan 20th, 2012 - about 13 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 | 1043394505 | NPPES |
| California | MEDICAID | 0A429611 |
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