| Baron Medical Group | |
|
817 S Ardmore Ave Fl 1 Los Angeles CA 90005-2411 | |
| (213) 210-3916 | |
| (213) 205-4918 |
| Full Name | Baron Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 817 S Ardmore Ave Fl 1, Los Angeles, California |
| Authorized Official Name and Position | Daesoon Leem (PRESIDENT) |
| Authorized Official Contact | 2132103916 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baron Medical Group 621 S Virgil Ave Ste 465 Los Angeles CA 90005-4017 Ph: (213) 210-3916 | Baron Medical Group 817 S Ardmore Ave Fl 1 Los Angeles CA 90005-2411 Ph: (213) 210-3916 |
| NPI Number | 1740969591 |
|---|---|
| Provider Enumeration Date | 07/17/2023 |
| Last Update Date | 07/27/2023 |
| Medicare PECOS PAC ID | 0042674459 |
|---|---|
| Medicare Enrollment ID | O20230918002233 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740969591 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Secondary |
| Provider Name | Daesoon Leem |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1902289226 PECOS PAC ID: 0749593697 Enrollment ID: I20200115000019 |
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