Doctor Name: | DOUGLAS J BESETH |
NPI Number: | 1336259720 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | C30121 |
Business Practice Address: | 999 San Bernardino Rd Upland, CA - 917864920 |
Business Phone Number: | 9099085086 |
Business Fax Number: | |
Mailing Address: | 1277 Upland Hills Dr S, UPLAND |
State: | CA |
Postal Code: | 917862439 |
Phone Number: | 9099085086 |
Fax Number: | |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 06/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | C30121 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |