| Pablo Bassuk M D Inc | |
|
1509 Wilson Ter Glendale CA 91206-4007 | |
| (323) 943-8577 | |
| Not Available |
| Full Name | Pablo Bassuk M D Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1509 Wilson Ter, Glendale, California |
| Authorized Official Name and Position | Pablo J Bassuk (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7472731129 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pablo Bassuk M D Inc Po Box 2027 Glendale CA 91209-2027 Ph: (747) 273-1129 | Pablo Bassuk M D Inc 1509 Wilson Ter Glendale CA 91206-4007 Ph: (323) 943-8577 |
| NPI Number | 1750773727 |
|---|---|
| Provider Enumeration Date | 02/26/2015 |
| Last Update Date | 07/09/2024 |
| Medicare PECOS PAC ID | 3072828813 |
|---|---|
| Medicare Enrollment ID | O20150821014773 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750773727 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A99057 (California) | Primary |
| Provider Name | Pablo J Bassuk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972625069 PECOS PAC ID: 3870692379 Enrollment ID: I20070625000469 |
| Provider Name | Viktorya Vicki Gezalian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073239851 PECOS PAC ID: 8729446554 Enrollment ID: I20230626002853 |
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