Individual
DR. TYLER BASEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
26691 PLAZA STE 170, MISSION VIEJO, CA 92691-6396
(949) 755-6414
(339) 207-0457
Mailing address
26691 PLAZA STE 170, MISSION VIEJO, CA 92691-6396
(949) 755-6414
(339) 207-0457
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
A141359
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CB299568
—
CA
Enumeration date
05/10/2013
Last updated
10/29/2020
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