Provider Demographics
NPI:1992877039
Name:BAIRD, ADRIAN BERNARD (OTR)
Entity type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:BERNARD
Last Name:BAIRD
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1636 IDLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-1028
Mailing Address - Country:US
Mailing Address - Phone:818-240-4935
Mailing Address - Fax:818-240-0794
Practice Address - Street 1:830 S CITRUS AVE.
Practice Address - Street 2:SUITE 203
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702
Practice Address - Country:US
Practice Address - Phone:626-339-6514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2060225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist