Provider Demographics
NPI:1316569635
Name:DOCTORS ON VIDEO
Entity Type:Organization
Organization Name:DOCTORS ON VIDEO
Other - Org Name:DOCTORS ON VIDEO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BASMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAADOUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:971-212-4164
Mailing Address - Street 1:13215 SW HAWKS BEARD ST APT 726
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-2125
Mailing Address - Country:US
Mailing Address - Phone:971-212-4164
Mailing Address - Fax:
Practice Address - Street 1:13215 SW HAWKS BEARD ST APT 726
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-2125
Practice Address - Country:US
Practice Address - Phone:971-212-4164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-08
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty