Organization
HANY BASTA, M.D., PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANY BASTA M.D. (PRESIDENT)
(626) 795-6596
Entity
Organization
Contact information
Practice address
2200 W 3RD ST, 120, LOS ANGELES, CA 90057-1932
(213) 207-5635
(213) 207-5889
Mailing address
225 S LAKE AVE, 535, PASADENA, CA 91101-3005
(626) 795-6596
(626) 795-8247
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A54439
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A544390
—
CA
01
—
6755130
PIN MEDI-CAL #
CA
Enumeration date
09/22/2006
Last updated
02/27/2008
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