Lida Bao, N.P.

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

13681 Issued in CA

Practice address

11301 Wilshire Blvd
Building 500
Los Angeles, CA 90073-1003

Phone

(310) 478-3711

NPI assigned

Dec 15, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1629130372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 S 8TH ST",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918033241",
            "telephone_number": "310-478-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD",
            "address_2": "BUILDING 500",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900731003",
            "telephone_number": "310-478-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAO",
        "first_name": "LIDA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "13681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP FURNISHING NUMBER",
            "identifier": "13681",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "559675",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victor Banuelos, RN
• Melissa Banuet, RADT
• Karambir Singh Banwait, DMD
• Karen Banzuela
• Danlin Bao, DPT
• Michelle Bao
• Nha Bao, MD
• Tien N P Bao, D.C.
• Trami Bao
• Yicheng Bao, MD

• Gerontology Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.