MEDICARE: BAILEY MULTISPECIALTY GROUP, INC.

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1952725673
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAILEY MULTISPECIALTY GROUP, INC.

Provider Business Mailing Address
First Line	:	1110 NORTON AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91202-2029
Country	:	US
Telephone Number	:	310-991-2896
Fax Number	:	707-598-3749

Provider Business Practice Location Address
First Line	:	1110 NORTON AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91202-2029
Country	:	US
Telephone Number	:	310-991-2896
Fax Number	:	707-598-3749

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BRIAN BAILEY
Credential	:
Telephone Number	:	310-991-2896

Provider Enumeration Date	:	02/17/2014
Last Update Date	:	02/17/2014

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