Healthcare Provider Details

I. General information

NPI: 1316475643
Provider Name (Legal Business Name): TROY BASSIRI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 AIRPORT RD
HOOPA CA
95546-9615
US

IV. Provider business mailing address

535 AIRPORT RD
HOOPA CA
95546-9615
US

V. Phone/Fax

Practice location:
  • Phone: 530-625-4261
  • Fax: 530-625-5171
Mailing address:
  • Phone: 530-625-4261
  • Fax: 530-625-5171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberS5841
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA188536
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: