Provider Demographics
NPI:1881645794
Name:BESSEN, STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:BESSEN
Suffix:
Gender:M
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:DEPT LA 21686
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91185-1686
Mailing Address - Country:US
Mailing Address - Phone:702-477-0772
Mailing Address - Fax:
Practice Address - Street 1:2555 MONTESSOURI ST
Practice Address - Street 2:SUITE C
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-3057
Practice Address - Country:US
Practice Address - Phone:702-477-0772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV87982085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV152970OtherWC
NV153104OtherWC
NVNV2045OtherBCBS
NVNV9914OtherBCBS
F98190Medicare UPIN
NVP00275361Medicare PIN
NV153104OtherWC
NVNV9914OtherBCBS