Provider Demographics
NPI:1679019202
Name:BALDWIN HILLS PEDIATRICS INC
Entity Type:Organization
Organization Name:BALDWIN HILLS PEDIATRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEGUSSIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-200-8045
Mailing Address - Street 1:3756 SANTA ROSALIA DR
Mailing Address - Street 2:SUITE#320
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-3606
Mailing Address - Country:US
Mailing Address - Phone:323-292-5600
Mailing Address - Fax:323-292-5611
Practice Address - Street 1:3756 SANTA ROSALIA DR
Practice Address - Street 2:SUITE#320
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-3606
Practice Address - Country:US
Practice Address - Phone:323-292-5600
Practice Address - Fax:323-292-5611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care