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NPI Code Detail

MEDICARE: BRADLEY LLOYD BAUM MD

MEDICARE:   BRADLEY LLOYD BAUM  MD
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
1207X00000XOrthopaedic Surgery PhysicianG51197CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3200034607OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100G511970OTHERCABLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
400G511970OTHERCABLUE CROSS

General Provider Information

NPI Number : 1205847654
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRADLEY LLOYD BAUM MD
Provider Business Mailing Address
First Line : 341 MAGNOLIA AVE
Second Line : STE 101
City : CORONA
State : CA
Zip : 92879-3331
Country : US
Telephone Number : 951-735-6060
Fax Number : 951-735-4510
Provider Business Practice Location Address
First Line : 341 MAGNOLIA AVE
Second Line : STE 101
City : CORONA
State : CA
Zip : 92879-3331
Country : US
Telephone Number : 951-735-6060
Fax Number : 951-735-4510
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 04/15/2011

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Directions to “ BRADLEY LLOYD BAUM MD” Practice Location

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