Provider Demographics
NPI:1528354610
Name:BASCO, DIGNA SANIDAD
Entity type:Individual
Prefix:
First Name:DIGNA
Middle Name:SANIDAD
Last Name:BASCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 MARINA WAY S UNIT C
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-3757
Mailing Address - Country:US
Mailing Address - Phone:510-741-8306
Mailing Address - Fax:510-724-8306
Practice Address - Street 1:931 MARINA WAY S UNIT C
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804-3757
Practice Address - Country:US
Practice Address - Phone:510-741-8306
Practice Address - Fax:510-724-8306
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5566490002Medicare NSC