Provider Demographics
NPI:1619068277
Name:BAUMAN, NORA STEPHANIE (DC)
Entity Type:Individual
Prefix:DR
First Name:NORA
Middle Name:STEPHANIE
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12926 RIVERSIDE DR STE A
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2292
Mailing Address - Country:US
Mailing Address - Phone:818-981-1713
Mailing Address - Fax:818-501-6789
Practice Address - Street 1:12926 RIVERSIDE DR STE A
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2292
Practice Address - Country:US
Practice Address - Phone:818-981-1713
Practice Address - Fax:818-501-6789
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15821111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC051821Medicaid
CA954361342OtherTAX ID
CA954361342OtherTAX ID