Healthcare Provider Details

I. General information

NPI: 1972566222
Provider Name (Legal Business Name): JOSEPH Y. BAO M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2006
Last Update Date: 04/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13132 STUDEBAKER RD SUITE 7A
NORWALK CA
90650-2557
US

IV. Provider business mailing address

13132 STUDEBAKER RD SUITE 7A
NORWALK CA
90650-2557
US

V. Phone/Fax

Practice location:
  • Phone: 562-868-3800
  • Fax: 562-868-3839
Mailing address:
  • Phone: 562-868-3800
  • Fax: 562-868-3839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberA53209
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: