Healthcare Provider Details

I. General information

NPI: 1841915089
Provider Name (Legal Business Name): RALPH H BAILEY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 10/10/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3756 SANTA ROSALIA DR STE 507
LOS ANGELES CA
90008-3656
US

IV. Provider business mailing address

2903 FAIRMAN ST
LAKEWOOD CA
90712-3633
US

V. Phone/Fax

Practice location:
  • Phone: 323-290-0832
  • Fax: 201-690-8448
Mailing address:
  • Phone: 323-228-3391
  • Fax: 201-690-8448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number13734
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: