Individual
BASIL O IKE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(999) 999-9999
Mailing address
200 S MANCHESTER AVE STE 835, ORANGE, CA 92868-3213
(800) 465-3203
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
20A19702
CA
Other
Enumeration date
03/21/2020
Last updated
05/10/2026
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