# LOUIS T BASCOY, M.D., INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BASCOY MEDICAL CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811339856
- **Authorized official:** DR. LOUIS T. BASCOY M.D. (OWNER/PRESIDENT)
- **Authorized official phone:** (323) 269-0411

## Contact information

- **Practice address:** 4560 E CESAR E CHAVEZ AVE, LOS ANGELES, CA 90022-1117
- **Practice address phone:** (323) 269-0411
- **Practice address fax:** (323) 269-0418
- **Mailing address:** 4560 E CESAR E CHAVEZ AVE, LOS ANGELES, CA 90022-1117
- **Mailing address phone:** (323) 269-0411
- **Mailing address fax:** (323) 269-0418

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | A29037 | CA | Yes |

## Other

- **Enumeration date:** 07/18/2013
- **Last updated:** 07/18/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00A290370 | — | CA |