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General NPI Number Information
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NPI Number | 1679019202
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Entity Type | Organization
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Legal Business Name | BALDWIN HILLS PEDIATRICS INC
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Dates
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Enumeration Date | 01/06/2017
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 3756 SANTA ROSALIA DR SUITE#320
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City | LOS ANGELES
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State | CA
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Zip | 90008-3606
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Country | US
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Telephone | 323-292-5600
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Fax | 323-292-5611
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Provider Business Mailing Address
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Address Line | 3756 SANTA ROSALIA DR SUITE#320
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City | LOS ANGELES
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State | CA
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Zip | 90008-3606
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Country | US
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Telephone | 323-292-5600
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Fax | 323-292-5611
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/ OWNER
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Name | DR. SUZANNA NEGUSSIE
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Credential | M.D.
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Telephone | 310-200-8045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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