Individual
BASEL GHEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1620 CUMMINS DR, MODESTO, CA 95358-6400
(209) 669-2583
Mailing address
1620 CUMMINS DR, MODESTO, CA 95358-6400
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/30/2014
Last updated
03/28/2016
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