Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 36097 | CA |
N | 207K00000X | Allergist & Immunologist | G36097 | CA |
NPI | 1124035076 |
---|---|
Provider Name | Dr. Marc Baskin |
First Address | Chicago, IL 60675-6008 |
Second Address | Bellflower, CA 90706-2602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 18/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G360970 | (05) | CA |
00G360970 | BLUE SHIELD (01) | CA |
00G36970 | (05) | CA |
030005091 | RAILROAD MEDICARE (01) | CA |
A46572 | (02) | |
A46572 | (02) | CA |