Provider Information for 1750984449
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BAILEY M BRONSON
Sex: Female
NPI: 1750984449
Last Updated: 2023-12-20
Certification Date: 2023-12-20
Certification Date: 2023-12-20
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1750984449 | ||||||||||||||||||||
| Enumeration Date | 2020-11-17 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 1718 XIMENO AVE APT 18 LONG BEACH, CA 90815-3727 United States Phone: 503-449-7316 | Fax: | ||||||||||||||||||||
| Primary Practice Address | 2116 ARLINGTON AVE STE 200 LOS ANGELES, CA 90018-1353 United States Phone: 562-338-7807 | Fax: | ||||||||||||||||||||
| Secondary Practice Address(es) | 5455 ALMIRA DR NE | ||||||||||||||||||||
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