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General NPI Number Information
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NPI Number | 1962469148
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Entity Type | Individual
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Provider Name | ANTHONY GERARD BASSANELLI MD
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Gender | Male
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Dates
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Enumeration Date | 04/29/2006
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Last Update Date | 09/26/2019
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Provider Practice Location Address
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Address Line | 44530 SAN PABLO AVE STE 202
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City | PALM DESERT
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State | CA
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Zip | 92260-3598
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Country | US
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Telephone | 760-341-6026
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Fax | 760-341-6027
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Provider Business Mailing Address
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Address Line | 44530 SAN PABLO AVE STE 202
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City | PALM DESERT
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State | CA
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Zip | 92260-3598
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Country | US
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Telephone | 760-341-6026
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Fax | 760-341-6027
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G55820
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License Number State | CA
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