Individual
MICKEY BAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
460 N MAGNOLIA AVE, EL CAJON, CA 92020-3610
(619) 933-0192
Mailing address
1238 QUINCY CANYON RD, LAKESIDE, CA 92040-1506
(619) 933-0192
Taxonomy
Speciality
Code
Description
License number
State
163WR0400X
Rehabilitation Registered Nurse
Primary
95290204
CA
Other
Enumeration date
07/31/2024
Last updated
07/31/2024
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