Provider Demographics
NPI:1215938949
Name:BASSLER, KARL DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:DAVID
Last Name:BASSLER
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 1:23961 MAGDALENA
Mailing Address - Street 2:#520
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653
Mailing Address - Country:US
Mailing Address - Phone:949-855-3376
Mailing Address - Fax:949-609-1971
Practice Address - Street 1:23961 MAGDALENA
Practice Address - Street 2:#520
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653
Practice Address - Country:US
Practice Address - Phone:949-855-3376
Practice Address - Fax:949-609-1971
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64015207N00000X, 207ND0900X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH17881OtherUPIN #
CADD4828OtherRAILROAD MEDICARE GROUP #
CAP00230697OtherRAILROAD MEDICARE PIN #
CAA64015OtherSTATE LICENSE NUMBER
CAA64015OtherSTATE LICENSE NUMBER
CADD4828OtherRAILROAD MEDICARE GROUP #
CA200912129OtherTAX ID NUMBER