Provider Demographics
NPI:1649316399
Name:BASIL R BESH MD INC
Entity type:Organization
Organization Name:BASIL R BESH MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BASIL
Authorized Official - Middle Name:R
Authorized Official - Last Name:BESH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-857-1000
Mailing Address - Street 1:39180 FARWELL DR
Mailing Address - Street 2:SUITE 211
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1000
Mailing Address - Country:US
Mailing Address - Phone:510-857-1000
Mailing Address - Fax:510-857-1001
Practice Address - Street 1:39180 FARWELL DR
Practice Address - Street 2:SUITE 211
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1000
Practice Address - Country:US
Practice Address - Phone:510-857-1000
Practice Address - Fax:510-857-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2017-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83582207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A835820Medicaid
CAZZZ28101ZMedicare PIN
CAY03907Medicare UPIN
CA00A835820Medicaid