MEDICARE: DR. JOSEPH DOMENIC BASSO DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	E1035	CA

General Provider Information

NPI Number	:	1588666077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH DOMENIC BASSO DPM

Provider Business Mailing Address
First Line	:	340 TARAVAL ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94116-1953
Country	:	US
Telephone Number	:	415-681-2208
Fax Number	:	415-665-0200

Provider Business Practice Location Address
First Line	:	340 TARAVAL ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94116-1953
Country	:	US
Telephone Number	:	415-681-2208
Fax Number	:	415-665-0200

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	10/07/2011

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