Doctor Name: | DR. JILIN BAI |
NPI Number: | 1003102856 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | A130116 |
Business Practice Address: | 631 E Colorado St Suite C Glendale, CA - 912055318 |
Business Phone Number: | 8185078181 |
Business Fax Number: | |
Mailing Address: | 631 E. Colorado St., Suite C GLENDALE |
State: | CA |
Postal Code: | 912055318 |
Phone Number: | 8185078181 |
Fax Number: | |
NPI Enumeration Date: | 06/21/2011 |
NPI Last Update Date: | 06/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A130116 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |