Healthcare Provider Details

I. General information

NPI: 1104264563
Provider Name (Legal Business Name): VICTORIA BARON RN A REGISTERED NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2013
Last Update Date: 06/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2403 ROCKEFELLER LN UNIT B
REDONDO BEACH CA
90278-3806
US

IV. Provider business mailing address

PO BOX 1155
REDONDO BEACH CA
90278-0155
US

V. Phone/Fax

Practice location:
  • Phone: 310-376-3847
  • Fax:
Mailing address:
  • Phone: 310-376-3847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: MS. VICTORIA BARON
Title or Position: PRESIDENT
Credential: C2890380
Phone: 310-376-3847