Healthcare Provider Details

I. General information

NPI: 1154525004
Provider Name (Legal Business Name): PAUL DAVID BAUM MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE WARD 86
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

1001 POTRERO AVE WARD 86
SAN FRANCISCO CA
94110-3518
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-2400
  • Fax:
Mailing address:
  • Phone: 415-206-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA72596
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: