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Individual

DR. JOHN LEE BASS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP, CNS, PHD

Contact information

Practice address
1010 MURRAY AVE, TRAUMA & EMERGENCY SURGERY, SVRMC, SAN LUIS OBISPO, CA 93405-1806
(805) 546-7821
Mailing address
TRAUMA & EMERGENCY SURGERY - 1010 MURRAY AVE., SIERRA VISTA REGIONAL MEDICAL CENTER, SAN LUIS OBIPSO, CA 93405
(805) 546-7821

Taxonomy

Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
14574
CA
364SE0003X
Emergency Clinical Nurse Specialist
2723
CA

Other

Enumeration date
06/18/2013
Last updated
06/18/2013
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