Individual
COREY BASCONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2315 STOCKTON BLVD. - DEPARTMENT OF SURGERY, NAOB 6TH FLOOR - PLASTICS, SACRAMENTO, CA 95817-2201
(973) 971-5000
Mailing address
2315 STOCKTON BLVD. - DEPARTMENT OF SURGERY, NAOB 6TH FLOOR - PLASTICS, SACRAMENTO, CA 95817-2201
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
A163351
CA
390200000X
Student in an Organized Health Care Education/Training Program
00000000000000000000
—
Other
Enumeration date
04/12/2017
Last updated
10/04/2019
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