Medical Board of California
Licensing details for: PTL 14794
Name: Theodory, Bassam
License Type: Postgraduate Training License
Primary Status: License Canceled

School Name: University of California, Riverside School of Medicine
Graduation Year: 2024
Current Enrolled Postgraduate Training Program
Facility Name: HCA Healthcare Riverside Program
City: Riverside
State: California
Speciality: Radiology-diagnostic
Start Date: 07/01/2025
Anticipated End Date: 06/30/2029
Address of Record
Riverside Community Hospital
4445 Magnolia Ave
RIVERSIDE CA 92501
RIVERSIDE county
Map
License Relationships
Postgraduate Training License associated with Physician & Surgeon License
License/Registration Role: Postgraduate Training License
Related Party Role: Physician & Surgeon
Name: Theodory, Bassam
License/Registration Type: Physician's and Surgeon's
License Number: 206651 Primary Status: License Renewed & Current
Address :
8228 Pecan Ave
RANCHO CUCAMONGA CA 91739-9268
SAN BERNARDINO COUNTY



