Provider Demographics
NPI:1407993694
Name:BASSETT, ELIZABETH LOVE (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:LOVE
Last Name:BASSETT
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Gender:F
Credentials:MD
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Mailing Address - Street 1:751 S BASCOM AVE
Mailing Address - Street 2:DEPARTMENT OF PEDIATRICS
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2604
Mailing Address - Country:US
Mailing Address - Phone:408-885-5445
Mailing Address - Fax:408-885-6718
Practice Address - Street 1:751 S BASCOM AVE
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2604
Practice Address - Country:US
Practice Address - Phone:408-885-5445
Practice Address - Fax:408-885-6718
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2022-02-11
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Provider Licenses
StateLicense IDTaxonomies
CAA89483208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics