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General NPI Number Information
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NPI Number | 1619635984
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Entity Type | Individual
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Provider Name | DANIELLE S BARUCH PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/03/2021
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 18133 VENTURA BLVD STE 300
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City | TARZANA
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State | CA
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Zip | 91356-3645
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Country | US
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Telephone | 818-981-3818
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Fax |
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Provider Business Mailing Address
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Address Line | 4140 W 190TH ST
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City | TORRANCE
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State | CA
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Zip | 90504-5513
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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 |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA63613
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License Number State | CA
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