Dr. Michael Tracy Basso, DPM
Assistant, Podiatric in Davis, CA. Individual provider (NPI-1).
NPI number1245814326
StatusActive
Last updated in NPPESMay 5, 2021
Details
- NPI
- 1245814326
- Entity type
- Individual (NPI-1)
- Name
- Dr. Michael Tracy Basso
- Credential
- DPM
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 5, 2021
- Certification date
- May 5, 2021
- Last updated
- May 5, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 211D00000X | Assistant, Podiatric | – | – | Yes |
Practice location
3216 Shelter Cove AveDavis, CA 95616-2628
Phone 530-601-3893
Mailing address
3216 Shelter Cove AveDavis, CA 95616-2628
Phone 530-601-3893
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