Healthcare Provider Details

I. General information

NPI: 1871088757
Provider Name (Legal Business Name): LARA BALDWIN CNM, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2018
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3921 W SUNSET BLVD FL 2
LOS ANGELES CA
90029-2241
US

IV. Provider business mailing address

3921 W SUNSET BLVD FL 2
LOS ANGELES CA
90029-2241
US

V. Phone/Fax

Practice location:
  • Phone: 646-650-5337
  • Fax: 646-871-6820
Mailing address:
  • Phone: 646-650-5337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number067880-23
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number067880-23
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberNMW236245
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: