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MR. HABIB MOUSSA BASHOURA MD

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1730170887

Individual Registrant:
MR. HABIB MOUSSA BASHOURA MD
Gender: M
Sole Proprietor

Location and contact information for practice:
1234 FOOTHILL BLVD #2 LA VERNE, CA 91750-3329 US
Tel: 909-596-4879  Fax: 909-596-9199

Contact information for business:
1234 FOOTHILL BLVD #2 LA VERNE, CA 91750-3329 US
Tel: 909-596-4879  Fax: 909-596-9199

Registration Information:
NPI: 1730170887
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
CAA52519

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
00A55191CA05




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