Individual provider Active NPI

Frank Edward Basa, M.D.

  • Legal Medicine
  • Burbank, CA
National Provider Identifier
1821063793
Registry record updated Oct 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
A75330 Issued in CA
Practice address
2701 W Alameda Ave
#403
Burbank, CA 91505-4402
Phone
(626) 940-8500
Fax
(626) 357-6743
NPI assigned
Feb 22, 2006
Last updated
Oct 22, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X A75330 CA Primary

Addresses

Primary practice location

2701 W Alameda Ave
#403
Burbank, CA 91505-4402

Mailing address

1110 S 10TH Ave
Arcadia, CA 91006-4505
Phone (626) 357-6769

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151006001628 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4880792001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
75330CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Motion Picture and Television Fund Medical Group Inc Past Accepting new patients
Motion Picture and Television Fund Medical Group, Inc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256169600000",
    "number": "1821063793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 S 10TH AVE",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910064505",
            "telephone_number": "626-357-6769",
            "fax_number": "626-357-6743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 W ALAMEDA AVE",
            "address_2": "#403",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054402",
            "telephone_number": "626-940-8500",
            "fax_number": "626-357-6743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASA",
        "first_name": "FRANK",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2009-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "CA",
            "license": "A75330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.