Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD23833 | AZ |
N | 111NI0900X | Internist | MD23833 | AZ |
N | 207RP1001X | Pulmonary Disease | MD23833 | AZ |
NPI | 1013998335 |
---|---|
Provider Name | Avtar S Bassin |
First Address | Peoria, AZ 85381-4158 |
Second Address | Peoria, AZ 85381-4158 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2005 |
Last Update Date | 08/07/2007 |