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General NPI Number Information
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NPI Number | 1629337845
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Entity Type | Individual
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Provider Name | LAWRENCE O BAUM JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/08/2012
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Last Update Date | 05/08/2012
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Provider Practice Location Address
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Address Line | 9226 SWALLOW DR 0
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City | LOS ANGELES
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State | CA
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Zip | 90069-1128
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Country | US
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Telephone | 310-275-6356
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Fax | 310-278-6046
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Provider Business Mailing Address
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Address Line | 9226 SWALLOW DR
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City | LOS ANGELES
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State | CA
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Zip | 90069-1128
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Country | US
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Telephone | 310-275-6356
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Fax | 310-278-6046
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | C24704
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | C 24704
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License Number State | CA
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