Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | G69886 | CA |
NPI | 1568689594 |
---|---|
Provider Name | Dr. Maxine Baum |
First Address | Beverly Hills, CA 90212-6693 |
Second Address | Los Angeles, CA 90048-5901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 08/07/2007 |