Provider Demographics
NPI:1316475643
Name:BASSIRI, TROY (MD)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:
Last Name:BASSIRI
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 1:535 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:HOOPA
Mailing Address - State:CA
Mailing Address - Zip Code:95546-9615
Mailing Address - Country:US
Mailing Address - Phone:530-625-4261
Mailing Address - Fax:530-625-5171
Practice Address - Street 1:535 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:HOOPA
Practice Address - State:CA
Practice Address - Zip Code:95546-9615
Practice Address - Country:US
Practice Address - Phone:530-625-4261
Practice Address - Fax:530-625-5171
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS5841207Q00000X
CAA188536207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine