Provider Demographics
NPI:1588811095
Name:BASI, MANPREET (MD)
Entity Type:Individual
Prefix:
First Name:MANPREET
Middle Name:
Last Name:BASI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MANPREET
Other - Middle Name:
Other - Last Name:BHULLAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:600 CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-2704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-2704
Practice Address - Country:US
Practice Address - Phone:833-447-2775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA104993207Q00000X
CODR.0055078207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine