Provider Demographics
NPI:1023239563
Name:BAILEY, ANN ELIZABETH (LICENSED ACUPUNCTURI)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:ELIZABETH
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LICENSED ACUPUNCTURI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 VISTA DEL MAR
Mailing Address - Street 2:5
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277
Mailing Address - Country:US
Mailing Address - Phone:310-462-3663
Mailing Address - Fax:
Practice Address - Street 1:1033 GAYLEY AVE
Practice Address - Street 2:SUITE 117
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024
Practice Address - Country:US
Practice Address - Phone:310-462-3663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA562529163W00000X
MDR040445163W00000X
CA8799171100000X
MDLL00191171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered171100000XOther Service ProvidersAcupuncturist