Provider Demographics
NPI:1841650199
Name:BASNET, NIRMAL (OWNER)
Entity type:Individual
Prefix:
First Name:NIRMAL
Middle Name:
Last Name:BASNET
Suffix:
Gender:M
Credentials:OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 BROADWAY
Mailing Address - Street 2:APT D
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-5347
Mailing Address - Country:US
Mailing Address - Phone:510-754-7565
Mailing Address - Fax:
Practice Address - Street 1:1226 BROADWAY
Practice Address - Street 2:APT D
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-5347
Practice Address - Country:US
Practice Address - Phone:510-754-7565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA820473344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi