Provider Demographics
NPI:1629337845
Name:BAUM, LAWRENCE O JR (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:O
Last Name:BAUM
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LARRY
Other - Middle Name:
Other - Last Name:BAUM
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9226 SWALLOW DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90069-1128
Mailing Address - Country:US
Mailing Address - Phone:310-275-6356
Mailing Address - Fax:310-278-6046
Practice Address - Street 1:9226 SWALLOW DR
Practice Address - Street 2:0
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90069-1128
Practice Address - Country:US
Practice Address - Phone:310-275-6356
Practice Address - Fax:310-278-6046
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC24704207RC0000X
CAC 24704207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease