Provider Demographics
NPI:1831393081
Name:BAKER CHIROPRACTIC INC.
Entity type:Organization
Organization Name:BAKER CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARYANN
Authorized Official - Middle Name:YUHAS
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-575-5535
Mailing Address - Street 1:2001 S BARRINGTON AVE
Mailing Address - Street 2:STE. 107
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5363
Mailing Address - Country:US
Mailing Address - Phone:310-575-5535
Mailing Address - Fax:310-575-5536
Practice Address - Street 1:2001 S BARRINGTON AVE
Practice Address - Street 2:STE. 107
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5363
Practice Address - Country:US
Practice Address - Phone:310-575-5535
Practice Address - Fax:310-575-5536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT15475225100000X
CADC22219111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty