Individual provider · NPI-1

Bassam Bader

Hospitalist · Riverside, CA

NPI number1487072559
StatusActive
Last updated in NPPESFeb 10, 2022

Details

NPI
1487072559
Entity type
Individual (NPI-1)
Name
Bassam Bader
Sex
Male
Sole proprietor
Yes
Enumeration date
Apr 4, 2014
Certification date
Feb 10, 2022
Last updated
Feb 10, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208M00000X HospitalistA170093CAYes
207R00000X Internal Medicine4301104969MI
208M00000X Hospitalist4301104969MI

Practice location

3865 Jackson St
Riverside, CA 92503-3919

Phone 714-676-3880

Mailing address

12223 Highland Ave Ste 106-526
Rancho Cucamonga, CA 91739-2574

Phone 714-676-3880

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