MEDICARE: MR. DAMIAN BAUM

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	106S00000X	Behavior Technician	RBT2687	NV

General Provider Information

NPI Number	:	1871248138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAMIAN BAUM

Provider Business Mailing Address
First Line	:	9950 W TROPICANA AVE APT 2104
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-8547
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5765 S RAINBOW BLVD STE 101-102
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2536
Country	:	US
Telephone Number	:	702-412-8578
Fax Number	:

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

Provider Enumeration Date	:	02/15/2022
Last Update Date	:	03/13/2024

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Directions to “ MR. DAMIAN BAUM ” Practice Location

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