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NPI Code Detail

MEDICARE: DAVID BAILEY

MEDICARE: DAVID BAILEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1154782555
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID BAILEY
Provider Business Mailing Address
First Line : 1631 W 214TH ST
Second Line :
City : TORRANCE
State : CA
Zip : 90501-2906
Country : US
Telephone Number : 818-693-1483
Fax Number :
Provider Business Practice Location Address
First Line : 2001 RIVER AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90810-3622
Country : US
Telephone Number : 562-200-7323
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2016
Last Update Date : 03/11/2016

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Directions to “ DAVID BAILEY ” Practice Location

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