Organization
LOUIS T BASCOY, M.D., INC.
Active
Other names
BASCOY MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS T. BASCOY M.D. (OWNER/PRESIDENT)
(323) 269-0411
Entity
Organization
Contact information
Practice address
4560 E CESAR E CHAVEZ AVE, LOS ANGELES, CA 90022-1117
(323) 269-0411
(323) 269-0418
Mailing address
4560 E CESAR E CHAVEZ AVE, LOS ANGELES, CA 90022-1117
(323) 269-0411
(323) 269-0418
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
A29037
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A290370
—
CA
Enumeration date
07/18/2013
Last updated
07/18/2013
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