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Individual
DR. MICHAEL WILLIAM BAUMANN
Active
Individual
DR. MICHAEL WILLIAM BAUMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT 8061
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GSD005170
—
CA
01
—
OPT 8061
CA LICENSE NUMBER
CA
01
—
SD0080610
BLUE SHIELD PROVIDER ID#
CA
05
—
SD0080610
—
CA
Enumeration date
06/23/2005
Last updated
07/09/2007
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