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Individual

MR. BASEM ISSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6444 N BEECHWOOD AVE, SAN BERNARDINO, CA 92407-4026
(909) 520-4542
Mailing address
6444 N BEECHWOOD AVE, SAN BERNARDINO, CA 92407-4026
(909) 520-4542

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
C6607310
CA

Other

Enumeration date
11/19/2021
Last updated
11/19/2021
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