Active NPI
Bradley Basinger, M.D.
- Surgery Physician
- Redlands, CA
National Provider Identifier
1023053592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- G68890
- Practice address
- 2 W Fern Ave
Redlands, CA 92373-5916 - Phone
- (909) 793-3311
- Fax
- (909) 796-4158
- NPI assigned
- Jun 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | G68890 | CA | Primary |
Addresses
Primary practice location
2 W Fern Ave
Redlands, CA 92373-5916
Mailing address
PO Box 10069
San Bernardino, CA 92423-0069
Phone (909) 335-4188
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G688900 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68890 | CA | MD | Pharmacist |
| G68890 | CA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428278400000",
"number": "1023053592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10069",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924230069",
"telephone_number": "909-335-4188",
"fax_number": "909-796-4158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 W FERN AVE",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923735916",
"telephone_number": "909-793-3311",
"fax_number": "909-796-4158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASINGER",
"first_name": "BRADLEY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-18",
"last_updated": "2015-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "G68890",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G688900",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.