Individual
BRADLEY LLOYD BAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
341 MAGNOLIA AVE, STE 101, CORONA, CA 92879-3331
(951) 735-6060
(951) 735-4510
Mailing address
341 MAGNOLIA AVE, STE 101, CORONA, CA 92879-3331
(951) 735-6060
(951) 735-4510
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G51197
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G511970
BLUE SHIELD
CA
05
—
00G511970
—
CA
01
—
200034607
RR MEDICARE
—
Enumeration date
08/11/2006
Last updated
04/15/2011
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