MEDICARE: DR. JENNIFER J BAIK M.D.

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	207K00000X	Allergy & Immunology Physician	A49466	CA

General Provider Information

NPI Number	:	1497764989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER J BAIK M.D.

Provider Business Mailing Address
First Line	:	300 S HOBART BLVD
Second Line	:	SUITE301
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-3635
Country	:	US
Telephone Number	:	213-385-9090
Fax Number	:	213-385-4728

Provider Business Practice Location Address
First Line	:	300 S HOBART BLVD
Second Line	:	SUITE301
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-3635
Country	:	US
Telephone Number	:	213-385-9090
Fax Number	:	213-385-4728

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	04/30/2010

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