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Individual

CAITLIN DATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1011 BALDWIN PARK BLVD, BALDWIN PARK, CA 91706-5806
(800) 780-1277
Mailing address
4733 W SUNSET BLVD, 3RD FLOOR, LOS ANGELES, CA 90027-6021

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A147188
CA

Other

Enumeration date
03/30/2015
Last updated
12/06/2021
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