Mouazzen, Bassam
Mouazzen, Bassam is an sole proprietor health care provider with primary practice located at 415 W Route 66 Suite 101, Glendora CA 91740-4335. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Mouazzen, Bassam can be contacted via phone (626) 852-9986.Contact Information
Primary practice address
415 W Route 66 Suite 101
Glendora CA 91740-4335
Phone: (626) 852-9986
Fax: (626) 963-2220
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | C43066 | California |
Profile Details
| NPI number | 1952492712 |
|---|---|
| LBN Legal business name | Mouazzen, Bassam |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 27th, 2006 |
| Last updated | Mar 7th, 2023 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952492712 | NPPES |
| California | Other | RHC140778 | FLOUROSCOPY |
| California | MEDICAID | 1625227 | FLOUROSCOPY |
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