Active NPI
Bassam Yassine, M.D.
- Family Medicine Physician
- West Covina, CA
National Provider Identifier
1497854483
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(4) exclusion effective Nov 18, 2010.
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A56483
- Practice address
- 1135 S. Sunset Ave Suite 301
West Covina, CA 91790 - Phone
- (626) 552-5459
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A56483 | CA | Primary |
Addresses
Primary practice location
1135 S. Sunset Ave Suite 301
West Covina, CA 91790
Mailing address
910 E Gladstone St
Azusa, CA 91702-4747
Phone (626) 339-9180
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A564830 | 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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A56483 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437350400000",
"number": "1497854483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 E GLADSTONE ST",
"city": "AZUSA",
"state": "CA",
"postal_code": "917024747",
"telephone_number": "626-339-9180",
"fax_number": "626-339-9130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1135 S. SUNSET AVE SUITE 301",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "91790",
"telephone_number": "626-552-5459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YASSINE",
"first_name": "BASSAM",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2015-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A56483",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A564830",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.