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NPI Code Detail

MEDICARE: BARBARA N BASS M.D.

MEDICARE: BARBARA N BASS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology PhysicianG66037CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100G660370OTHERCAPTAN

General Provider Information

NPI Number : 1518960327
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA N BASS M.D.
Provider Business Mailing Address
First Line : 2221 CARVER CT
Second Line :
City : SIMI VALLEY
State : CA
Zip : 93063-2616
Country : US
Telephone Number : 760-446-6404
Fax Number : 760-446-6415
Provider Business Practice Location Address
First Line : 1041 N CHINA LAKE BLVD
Second Line : STE B
City : RIDGECREST
State : CA
Zip : 93555-3183
Country : US
Telephone Number : 760-446-6404
Fax Number : 760-446-6415
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 04/07/2010

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Directions to “ BARBARA N BASS M.D.” Practice Location

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