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General NPI Number Information
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NPI Number | 1669532818
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Entity Type | Organization
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Legal Business Name | DR ELIZABETH R BAYLON DMD INC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 555 S CALIFORNIA AVE
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City | WEST COVINA
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State | CA
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Zip | 91790
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Country | US
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Telephone | 626-814-8377
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Fax | 626-814-3007
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Provider Business Mailing Address
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Address Line | 555 S CALIFORNIA AVE
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City | WEST COVINA
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State | CA
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Zip | 91790
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Country | US
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Telephone | 626-814-8377
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Fax | 626-814-3007
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Authorized Official
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Title or Position | DENTIST OWNER
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Name | DR. ELIZABETH REYES BAYLON
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Credential | DMD
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Telephone | 626-814-8377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 38964
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License Number State | CA
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