Provider Demographics
NPI:1982232146
Name:BAUMANN, DANIELA
Entity type:Individual
Prefix:DR
First Name:DANIELA
Middle Name:
Last Name:BAUMANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 WILSHIRE BLVD STE 504
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-3906
Mailing Address - Country:US
Mailing Address - Phone:800-898-2020
Mailing Address - Fax:844-897-3788
Practice Address - Street 1:1127 WILSHIRE BLVD STE 504
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-3906
Practice Address - Country:US
Practice Address - Phone:800-898-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-31
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAOPT34530-TGL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program