Organization
PAUL B BASCOM MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL B BASCOM M.D. (OWNER)
(503) 961-2017
Entity
Organization
Contact information
Practice address
94220 4TH ST, GOLD BEACH, OR 97444-7756
(503) 961-2017
Mailing address
2660 CRIMSON CANYON DR STE 130, LAS VEGAS, NV 89128-0846
(503) 961-2017
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD16983
OR
Other
Enumeration date
04/25/2014
Last updated
08/09/2023
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