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Organization
JESSICA BASA, M.D., INC.
Active
Organization
JESSICA BASA, M.D., INC.
Active
Other names
Barstow Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA BASA M.D. (C.E.O.)
(760) 256-1227
Entity
Organization
Contact information
Practice address
705 E VIRGINIA WAY, SUITE F, BARSTOW, CA 92311-3978
(760) 256-1227
(760) 256-1239
Mailing address
705 E VIRGINIA WAY, SUITE F, BARSTOW, CA 92311-3978
(760) 256-1227
(760) 256-1239
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A053608
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DP3351
RAILROAD MEDICARE
—
01
—
ZZZ54503Z
BLUE SHIELD CA
—
Enumeration date
03/28/2007
Last updated
06/29/2010
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