MEDICARE: DR. HANI BAUMGARTEN PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PSY18469	CA

General Provider Information

NPI Number	:	1558502351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HANI BAUMGARTEN PSY.D.

Provider Business Mailing Address
First Line	:	1032 IRVING ST # 783
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94122-2216
Country	:	US
Telephone Number	:	415-254-1793
Fax Number	:

Provider Business Practice Location Address
First Line	:	1032 IRVING ST # 783
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94122-2216
Country	:	US
Telephone Number	:	415-254-1793
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2009
Last Update Date	:	03/09/2009

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