Healthcare Provider Details

I. General information

NPI: 1144460403
Provider Name (Legal Business Name): ELIZABETH BACHNER LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2009
Last Update Date: 05/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 W SUNSET BLVD STE 105
LOS ANGELES CA
90026-2168
US

IV. Provider business mailing address

2815 W SUNSET BLVD STE 105
LOS ANGELES CA
90026-2168
US

V. Phone/Fax

Practice location:
  • Phone: 323-379-4614
  • Fax: 323-430-8054
Mailing address:
  • Phone: 323-963-3868
  • Fax: 323-430-8054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number215
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC8601
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: