Fawzy Samy Basta SR. MD

NPI 1043394505 - Psychiatry & Neurology - 2084P0800X

NPI Details
NPI 1043394505
Gender Male
Enumeration Date 10/24/2006
Last Updated 01/20/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
17075 DEVONSHIRE ST
STE 204
NORTHRIDGE CA, 91325-5408, US
Phone (818) 368-8929
Fax (818) 368-8940
Business Location
17075 DEVONSHIRE ST
STE 204
NORTHRIDGE CA, 91325-1600, US
Phone (818) 368-8929
Fax (818) 368-8940
Toxanomy
Taxonomy Code 2084P0800X
License State California
License Number A42961
Remove 1043394505 NPI Number
 

According to our database, Dr. Fawzy Samy Basta SR. MD NPI is 1043394505, taxonomy code is 2084P0800X and license number is A42961, license state is located at California. Fawzy Samy Basta SR. MD physically located at 17075 Devonshire St, Northridge CA, 91325-5408. NPI Number Fawzy Samy Basta SR. MD has the Individual type.

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1043394505 NPI number is provided on an as is basis without warranty of any kind. 1043394505 is maintained by the National Plan & Provider Enumeration System. The contents of Fawzy Samy Basta SR. MD are for informational purposes only.