Provider Demographics
NPI:1124015888
Name:AISH, BASSIL (MD)
Entity Type:Individual
Prefix:
First Name:BASSIL
Middle Name:
Last Name:AISH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:17742 BEACH BLVD
Mailing Address - Street 2:STE 215
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6818
Mailing Address - Country:US
Mailing Address - Phone:714-848-1655
Mailing Address - Fax:714-847-4348
Practice Address - Street 1:17742 BEACH BLVD
Practice Address - Street 2:STE 215
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6818
Practice Address - Country:US
Practice Address - Phone:714-848-1655
Practice Address - Fax:714-847-4348
Is Sole Proprietor?:No
Enumeration Date:2005-09-28
Last Update Date:2010-01-05
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Provider Licenses
StateLicense IDTaxonomies
CAA60644207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H08327Medicare UPIN