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Organization
HABIB MOUSSA BASHOURA MD INC
Active
Organization
HABIB MOUSSA BASHOURA MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HABIB BASHOURA MD (PHYSICIAN)
(909) 596-4879
Entity
Organization
Contact information
Practice address
1234 FOOTHILL BLVD, LA VERNE, CA 91750
(909) 596-4879
(909) 596-6612
Mailing address
1234 FOOTHILL BLVD, LA VERNE, CA 91750
(909) 596-4879
(909) 596-6612
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A525191
—
CA
Enumeration date
10/27/2006
Last updated
12/15/2016
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