| Benjamin Basseri MD Inc. | |
|
8631 W 3rd St Ste 1015e Los Angeles CA 90048-5925 | |
| (310) 652-4472 | |
| (310) 358-2266 |
| Full Name | Benjamin Basseri MD Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 8631 W 3rd St Ste 1015e, Los Angeles, California |
| Authorized Official Name and Position | Benjamin Basseri (CEO) |
| Authorized Official Contact | 3109222613 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin Basseri MD Inc. 8631 W 3rd St Ste 1015e Los Angeles CA 90048-5925 Ph: (310) 855-5855 | Benjamin Basseri MD Inc. 8631 W 3rd St Ste 1015e Los Angeles CA 90048-5925 Ph: (310) 652-4472 |
| NPI Number | 1578908422 |
|---|---|
| Provider Enumeration Date | 05/06/2013 |
| Last Update Date | 07/23/2024 |
| Certification Date | 07/23/2024 |
| Medicare PECOS PAC ID | 3375782584 |
|---|---|
| Medicare Enrollment ID | O20130619000646 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578908422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | () | Primary |
| Provider Name | Khodadad Mehraein |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1316147374 PECOS PAC ID: 6002902236 Enrollment ID: I20071018000460 |
| Provider Name | Todd a Glauser |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1336139773 PECOS PAC ID: 6305837899 Enrollment ID: I20110505000480 |
| Provider Name | Jin Guo |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1538375217 PECOS PAC ID: 1254587553 Enrollment ID: I20120801000652 |
| Provider Name | Benjamin Basseri |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1801059647 PECOS PAC ID: 4284873498 Enrollment ID: I20130619000653 |
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