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NPI Code Detail

MEDICARE: JASON BASS

MEDICARE: JASON BASS
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1649306994
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON BASS
Provider Business Mailing Address
First Line : 2055 LINCOLN AVE
Second Line :
City : PASADENA
State : CA
Zip : 91103-1324
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2055 LINCOLN AVE
Second Line :
City : PASADENA
State : CA
Zip : 91103-1324
Country : US
Telephone Number : 626-798-6793
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2007
Last Update Date : 08/10/2009

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Directions to “ JASON BASS ” Practice Location

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