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General NPI Number Information
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NPI Number | 1245513167
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Entity Type | Individual
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Provider Name | MS. KIRIN KAUR BASUTA
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Gender | Female
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Dates
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Enumeration Date | 09/27/2011
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | SOCIAL MEDICINE 25975 S. NORMANDIE AVE
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City | HARBOR CITY
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State | CA
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Zip | 90710
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Country | US
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Telephone | 424-251-7794
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Fax |
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Provider Business Mailing Address
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Address Line | 25975 NORMANDIE AVE DEPT OF
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City | HARBOR CITY
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State | CA
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Zip | 90710-3416
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Country | US
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Telephone | 424-251-7794
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW80385
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License Number State | CA
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