Individual
ANICK BAZILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMS, PA-C
Contact information
Practice address
192 BEACON ST, SOUTH SAN FRANCISCO, CA 94080-6913
(650) 589-6500
Mailing address
192 BEACON ST, SOUTH SAN FRANCISCO, CA 94080-6913
(650) 589-6500
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9112564
FL
Other
Enumeration date
10/31/2019
Last updated
03/15/2020
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