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General NPI Number Information
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NPI Number | 1336691740
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Entity Type | Organization
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Legal Business Name | JILIN BAI MD PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 11/01/2016
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Last Update Date | 08/30/2018
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Provider Practice Location Address
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Address Line | 25775 MCBEAN PKWY STE 106
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City | SANTA CLARITA
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State | CA
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Zip | 91355-3702
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Country | US
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Telephone | 661-263-5033
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Fax | 661-254-4285
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Provider Business Mailing Address
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Address Line | 27522 ARTINE DR
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City | SANTA CLARITA
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State | CA
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Zip | 91350-2182
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JILIN BAI
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Credential | M.D.
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Telephone | 860-882-8173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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