Individual
ROBERT BASTING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1920 FELSPAR ST APT 4, SAN DIEGO, CA 92109-3522
(414) 614-4611
Mailing address
1920 FELSPAR ST APT 4, SAN DIEGO, CA 92109-3522
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
104646
CA
Other
Enumeration date
02/10/2019
Last updated
02/10/2019
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