# DOUGLAS J BESETH MD A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902019672
- **Authorized official:** DR. DOUGLAS J BESETH MD (PHYSICIAN)
- **Authorized official phone:** (909) 908-5086

## Contact information

- **Practice address:** 999 SAN BERNARDINO RD, UPLAND, CA 91786-4920
- **Practice address phone:** (909) 908-5086
- **Mailing address:** 1277 UPLAND HILLS DR S, UPLAND, CA 91786-2439
- **Mailing address phone:** (909) 908-5086

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | C30121 | CA | Yes |

## Other

- **Enumeration date:** 05/08/2007
- **Last updated:** 06/13/2013