| Habib Moussa Bashoura Md Inc | |
| 
					1234 Foothill Blvd La Verne CA 91750  | |
| (909) 596-4879 | |
| (909) 596-6612 | 
| Full Name | Habib Moussa Bashoura Md Inc | 
|---|---|
| Speciality | Family Medicine | 
| Location | 1234 Foothill Blvd, La Verne, California | 
| Authorized Official Name and Position | Habib Bashoura (PHYSICIAN) | 
| Authorized Official Contact | 9095964879 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Habib Moussa Bashoura Md Inc 1234 Foothill Blvd La Verne CA 91750 Ph: (909) 596-4879  | Habib Moussa Bashoura Md Inc 1234 Foothill Blvd La Verne CA 91750 Ph: (909) 596-4879  | 
| NPI Number | 1609952431 | 
|---|---|
| Provider Enumeration Date | 10/27/2006 | 
| Last Update Date | 12/15/2016 | 
| Medicare PECOS PAC ID | 6507923091 | 
|---|---|
| Medicare Enrollment ID | O20090327000339 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1609952431 | NPI | - | NPPES | 
| 00A525191 | Medicaid | CA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary | 
| Provider Name | Habib M Bashoura | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1730170887 PECOS PAC ID: 7012093768 Enrollment ID: I20090327000333  | 
Premier Family Medicine Associates, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2333 Foothill Blvd Ste B, La Verne, CA 91750 Phone: 909-392-6501 Fax: 909-469-2136  | |
May Medical Management Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1234 Foothill Blvd, La Verne, CA 91750 Phone: 909-596-4879 Fax: 909-596-9199  | |
La Verne Family Medical Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2100 Foothill Blvd, Suite A, La Verne, CA 91750 Phone: 909-596-1941 Fax: 909-596-1943  | |
Donald J Guido Od Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2248 D St, La Verne, CA 91750 Phone: 909-593-3519 Fax: 909-593-3521  |