Healthcare Provider Details

I. General information

NPI: 1013998335
Provider Name (Legal Business Name): AVTAR S BASSIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13352 N 83RD AVE SUITE #A 100
PEORIA AZ
85381-4158
US

IV. Provider business mailing address

13352 N 83RD AVE SUITE #A 100
PEORIA AZ
85381-4158
US

V. Phone/Fax

Practice location:
  • Phone: 623-977-8871
  • Fax: 623-977-4826
Mailing address:
  • Phone: 623-977-8871
  • Fax: 623-977-4826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD23833
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD23833
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: