Healthcare Provider Details

I. General information

NPI: 1598565483
Provider Name (Legal Business Name): ERWIN BAIRD PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2025
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5222 BALBOA AVE STE 43
SAN DIEGO CA
92117-6956
US

IV. Provider business mailing address

8605 SANTA MONICA BLVD # 373391
WEST HOLLYWOOD CA
90069-4109
US

V. Phone/Fax

Practice location:
  • Phone: 323-527-2091
  • Fax: 323-334-1456
Mailing address:
  • Phone: 323-250-0336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95034143
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: