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Kelly Bascom

NPI 1265869937 · on the registry since 2013 · sole proprietor

Practice

Address
44979 15th St West
Lancaster, CA 93534
Phone
(661) 264-8235
Fax
(661) 802-4727

Registry record

Primary taxonomy
164X00000X
164X00000X
Also registered as
164W00000X
347C00000X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2013-09-26

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California