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Organization

BASS MEDICAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
INEZ WONDEH (CEO)
(925) 378-4512
Entity
Organization

Contact information

Practice address
5127 W NOBLE AVE, VISALIA, CA 93291
(559) 713-6515
(559) 713-6516
Mailing address
2637 SHADELANDS DR, WALNUT CREEK, CA 94598-2512
(925) 627-3424
(925) 627-3560

Taxonomy

Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7360010007
MEDICARE NCS
Enumeration date
03/18/2016
Last updated
10/18/2023
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