| Tsilya Bass Md Inc | |
|
1111 N Fairfax Ave Ste 109 West Hollywood CA 90046-5363 | |
| (323) 876-1500 | |
| (323) 876-1515 |
| Full Name | Tsilya Bass Md Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1111 N Fairfax Ave Ste 109, West Hollywood, California |
| Authorized Official Name and Position | Tsilya Bass (PHISICIAN) |
| Authorized Official Contact | 3238761500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tsilya Bass Md Inc 1111 N Fairfax Ave Ste 109 West Hollywood CA 90046-5363 Ph: (323) 876-1500 | Tsilya Bass Md Inc 1111 N Fairfax Ave Ste 109 West Hollywood CA 90046-5363 Ph: (323) 876-1500 |
| NPI Number | 1669507273 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 07/07/2020 |
| Certification Date | 07/07/2020 |
| Medicare PECOS PAC ID | 3779635677 |
|---|---|
| Medicare Enrollment ID | O20090723000004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669507273 | NPI | - | NPPES |
| 00A636300 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A63630 (California) | Primary |
| 208D00000X | General Practice | A63630 (California) | Secondary |
| Provider Name | Tsilya Bass |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841330800 PECOS PAC ID: 7315991916 Enrollment ID: I20050307000563 |
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