Individual
PAUL BENJAMIN BASCOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
94220 4TH ST, GOLD BEACH, OR 97444-7756
(702) 453-3799
(702) 453-5741
Mailing address
2660 CRIMSON CANYON DR STE 130, LAS VEGAS, NV 89128-0846
(702) 453-3799
(702) 453-5741
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
G061983
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040563
—
OR
Enumeration date
08/01/2006
Last updated
08/09/2023
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