Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bassam Theodory, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1790545986

Bassam Theodory, MD is a Student in an Organized Health Care Education/Training Program in Fontana, California. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

17234 Valley Blvd Bldg A
Fontana, CA 92335
Phone: (626) 400-7101
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1790545986
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 22, 2024
Last updated in NPPESMarch 22, 2024
Certification dateMarch 19, 2024

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