Healthcare Provider Details

I. General information

NPI: 1124110069
Provider Name (Legal Business Name): ANDRIUS BASKYS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 11/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5887 BROCKTON AVE SUITE B
RIVERSIDE CA
92506-1853
US

IV. Provider business mailing address

PO BOX 9287
NEWPORT BEACH CA
92658-9287
US

V. Phone/Fax

Practice location:
  • Phone: 951-275-8500
  • Fax: 951-275-8560
Mailing address:
  • Phone: 877-483-2071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberA64874
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA64874
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberA64874
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: