Provider Demographics
NPI:1437491362
Name:BESSOLO, CAROLINE HAAS (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:HAAS
Last Name:BESSOLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 HARTGLEN AVE
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2025
Mailing Address - Country:US
Mailing Address - Phone:805-231-2954
Mailing Address - Fax:
Practice Address - Street 1:870 HARTGLEN AVE
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2025
Practice Address - Country:US
Practice Address - Phone:805-231-2954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG61807207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology