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Individual

DR. MICHAEL PERRY BASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
515 MICHIGAN BLVD, WEST SACRAMENTO, CA 95691-2705
(916) 368-0816
(916) 469-2273
Mailing address
515 MICHIGAN BLVD, WEST SACRAMENTO, CA 95691-2705
(916) 368-0816
(916) 469-2273

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
C32503
CA
207T00000X
Neurological Surgery Physician
C32503
CA
208D00000X
General Practice Physician
Primary
C32503
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
GROUP'S PTAN HJ036A
GROUP'S PTAN HJ036A
CA
Enumeration date
09/19/2006
Last updated
01/28/2014
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