Individual
DR. BRIAN ROBERT BAUCOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
6310 SAN VICENTE BLVD, SUITE 350, LOS ANGELES, CA 90048-5426
(310) 625-9267
Mailing address
6310 SAN VICENTE BLVD, SUITE 350, LOS ANGELES, CA 90048-5426
(310) 625-9267
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSB 33264
CA
Other
Enumeration date
07/15/2008
Last updated
12/10/2024
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