Individual
LEAH NICHOLE BASCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
39000 BOB HOPE DR, RANCHO MIRAGE, CA 92270-3221
(760) 674-3667
(760) 674-3857
Mailing address
39000 BOB HOPE DR, RANCHO MIRAGE, CA 92270-3221
(760) 674-3667
(760) 674-3857
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
0110002884
VA
363AS0400X
Surgical Physician Assistant
50.003762
OH
363AS0400X
Surgical Physician Assistant
Primary
64265
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0083751
—
OH
01
—
50.003762
LICENSE
OH
Enumeration date
10/01/2008
Last updated
05/22/2024
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