# BASRI MD DIABETES RELIEF PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DIABETES RELIEF CENTER OF BRONX MSO LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1730691171
- **Legal business name:** DIABETES RELIEF CENTER OF BRONX MSO LLC
- **Authorized official:** DEANE WALLACE (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (916) 571-9041

## Contact information

- **Practice address:** 2825 3RD AVE STE 200, BRONX, NY 10455-4066
- **Practice address phone:** (916) 550-1050
- **Practice address fax:** (916) 550-1238
- **Mailing address:** 4441 AUBURN BLVD STE J, SACRAMENTO, CA 95841-4139
- **Mailing address phone:** (916) 550-1050
- **Mailing address fax:** (916) 550-1238

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/25/2017
- **Last updated:** 10/25/2017