MEDICARE: WILLIAM BAO, MD INC

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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1477639789
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM BAO, MD INC

Provider Business Mailing Address
First Line	:	17595 ALMAHURST ST STE 202
Second Line	:
City	:	CITY OF INDUSTRY
State	:	CA
Zip	:	91748-1799
Country	:	US
Telephone Number	:	626-581-4990
Fax Number	:	626-581-4011

Provider Business Practice Location Address
First Line	:	17595 ALMAHURST ST STE 202
Second Line	:
City	:	CITY OF INDUSTRY
State	:	CA
Zip	:	91748-1799
Country	:	US
Telephone Number	:	626-581-4990
Fax Number	:	626-581-4011

Authorized Official
Title or Position	:	PROVIDER/PRESIDENT
Name	:	DR. WILLIAM BAO
Credential	:	M.D.
Telephone Number	:	626-581-4990

Provider Enumeration Date	:	10/29/2006
Last Update Date	:	08/22/2020

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