Provider Demographics
NPI:1346415346
Name:NABER, BASSAM MICHAEL (DC)
Entity Type:Individual
Prefix:
First Name:BASSAM
Middle Name:MICHAEL
Last Name:NABER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18531 ROSCOE BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-5973
Mailing Address - Country:US
Mailing Address - Phone:818-341-9775
Mailing Address - Fax:
Practice Address - Street 1:18531 ROSCOE BLVD STE 210
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-5973
Practice Address - Country:US
Practice Address - Phone:818-341-9775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor