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Lida Bao, NP
Gerontology Nurse Practitioner in Los Angeles, California
NPI 1629130372

Lida Bao is a Gerontology Nurse Practitioner based in Alhambra, CA and is specialized in Gerontology. Lida Bao practices in Los Angeles, CA and has the professional credentials of NP. The NPI Number for Lida Bao is 1629130372 and holds a License No. 13681 (California).

The current practice location address for Lida Bao is 11301 Wilshire Blvd, Los Angeles, CA and can be reached out via phone at 310-478-3711.

Location: 11301 Wilshire Blvd, Los Angeles, CA, 91803-3241
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Provider Profile Details
NPI Number
1629130372
Provider Name
Lida Bao
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
11301 Wilshire Blvd, Los Angeles, CA, 91803-3241
Phone Number
310-478-3711
Fax Number
Provider Enumeration Date
12/15/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
13681 01 CA NP FURNISHING NUMBER
559675 01 CA REGISTERED NURSE LICENSE
institution
Provider Business Practice Location Address Details
Address
11301 Wilshire Blvd
City
State
Zip
90073-1003
Phone Number
310-478-3711
Fax Number
person
Provider Business Mailing Address Details
Address
11301 Wilshire Blvd
City
State
Zip
90073-1003
Phone Number
310-478-3711
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
License No.
13681 (California)
Definition
Definition to come...
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