Habib Moussa Bashoura MD Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HABIB MOUSSA BASHOURA MD INC

Practice address

1234 Foothill Blvd
La Verne, CA 91750

Phone

(909) 596-4879

Fax

(909) 596-6612

NPI assigned

Oct 27, 2006

Last updated

Dec 15, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Habib Bashoura, MDNPI 1730170887

Title

Physician

Phone

(909) 596-4879

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Habib Moussa Bashoura, MD

  • Family Medicine Physician
  • La Verne, CA
  • NPI 1730170887
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481760000000",
    "number": "1609952431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 FOOTHILL BLVD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "91750",
            "telephone_number": "909-596-4879",
            "fax_number": "909-596-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 FOOTHILL BLVD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "91750",
            "telephone_number": "909-596-4879",
            "fax_number": "909-596-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HABIB MOUSSA BASHOURA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2016-12-15",
        "status": "A",
        "authorized_official_last_name": "BASHOURA",
        "authorized_official_first_name": "HABIB",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "909-596-4879",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A525191",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in La Verne, CA
• Providers in La Verne, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.