MEDICARE: TARUN BASSI MD

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
1	207R00000X	Internal Medicine Physician	46926	WI
2	207R00000X	Internal Medicine Physician	56559	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538277587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARUN BASSI MD

Provider Business Mailing Address
First Line	:	11110 N TATUM BLVD STE 103
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85028-1607
Country	:	US
Telephone Number	:	602-354-3311
Fax Number	:	602-354-3751

Provider Business Practice Location Address
First Line	:	11110 N TATUM BLVD STE 103
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85028-1607
Country	:	US
Telephone Number	:	602-354-3311
Fax Number	:	602-354-3751

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	01/07/2025

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Directions to “ TARUN BASSI MD” Practice Location

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