Individual
DR. MARK BASHA KEROLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30051 GRANDPOINT LN, RANCHO PALOS VERDES, CA 90275-6425
(484) 351-8459
Mailing address
2915 W BITTERS RD STE 201, SAN ANTONIO, TX 78248-2007
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
A187307
CA
Other
Enumeration date
03/27/2020
Last updated
03/31/2026
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