Abraham Tonatiuh Baltazar

Primary specialty

Social WorkerTaxonomy code 104100000X

License

ASW123797 Issued in CA

Practice address

4760 Sepulveda Blvd
Culver City, CA 90230-4820

Phone

(310) 390-6612

NPI assigned

Jul 8, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1891531018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 W MANCHESTER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900442240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304820",
            "telephone_number": "310-390-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTAZAR",
        "first_name": "ABRAHAM",
        "middle_name": "TONATIUH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW123797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Eileen Baker, D.P.T
• Kelsy Balcom
• Evelyn Balingit
• Yvette Ballesteros-Lara
• Oluwatoyin Balogun
• Melissa Marie Balzano
• Shiva Banafti
• Waka Fukuhara Banchi, RD
• Nubia Bandek
• Kanyinsola Adenike Banigo, CCC-SLP

• Social Worker in Culver City, CA
• Providers in Culver City, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.