Provider Demographics
NPI:1699464487
Name:BASSAM BILAL MD INC
Entity type:Organization
Organization Name:BASSAM BILAL MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/ CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BASSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BILAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-344-5662
Mailing Address - Street 1:15642 SAND CANYON AVE UNIT 54102
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92619-5439
Mailing Address - Country:US
Mailing Address - Phone:949-344-5662
Mailing Address - Fax:949-502-8887
Practice Address - Street 1:260 MERIT
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-1416
Practice Address - Country:US
Practice Address - Phone:949-344-5662
Practice Address - Fax:949-502-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center