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General NPI Number Information
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NPI Number | 1104027630
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Entity Type | Individual
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Provider Name | AMIR LEBASCHI D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 03/17/2020
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Provider Practice Location Address
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Address Line | 2220 E FRUIT ST STE 21 SUITE 214
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City | SANTA ANA
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State | CA
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Zip | 92701-4459
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Country | US
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Telephone | 714-547-7100
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Fax | 714-547-7300
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Provider Business Mailing Address
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Address Line | 2220 E FRUIT ST SUITE 214
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City | SANTA ANA
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State | CA
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Zip | 92701-4459
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Country | US
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Telephone | 714-547-7100
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Fax | 714-547-7300
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E 4838
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License Number State | CA
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