Individual
DR. TRACY LEE BASSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
635 ANDERSON RD, STE 19, DAVIS, CA 95616-3505
(530) 758-1810
(530) 758-1896
Mailing address
635 ANDERSON RD, STE 19, DAVIS, CA 95616-3505
(530) 758-1810
(530) 758-1896
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E36260
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E36260
—
CA
Enumeration date
06/22/2005
Last updated
05/23/2022
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