Provider Demographics
NPI:1760968754
Name:BAILEY, CEDRIC (DO)
Entity Type:Individual
Prefix:
First Name:CEDRIC
Middle Name:
Last Name:BAILEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8700 BEVERLY PATHOLOGY
Mailing Address - Street 2:CEDARS-SINAI MEDICAL CENTER PATHOLOGY & LAB MEDICINE
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:310-423-5431
Mailing Address - Fax:
Practice Address - Street 1:8700 BEVERLY PATHOLOGY
Practice Address - Street 2:CEDARS-SINAI MEDICAL CENTER PATHOLOGY & LAB MEDICINE
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-423-5431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A20696207ZP0102X
MO2018019770207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A20696OtherOSTEOPATHIC MEDICAL BOARD OF CALIFORNIA
MO2018019770OtherMISSOURI DIVISION OF PROFESSIONAL REGISTRATION