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General NPI Number Information
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NPI Number | 1427290030
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Entity Type | Individual
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Provider Name | GERALD M BALTZ DNP
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Gender | Male
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 06/01/2020
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Provider Practice Location Address
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Address Line | 8060 MELROSE AVE STE 200
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City | LOS ANGELES
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State | CA
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Zip | 90046-7037
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Country | US
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Telephone | 323-391-4830
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Fax | 323-978-2546
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Provider Business Mailing Address
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Address Line | 1412 3/4 N HAYWORTH AVE
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90046-3809
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Country | US
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Telephone | 323-391-4830
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Fax | 323-978-2546
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 19710
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License Number State | CA
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