Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 42990 | AZ |
N | 2081P2900X | Pain Medicine | 42990 | AZ |
NPI | 1235342775 |
---|---|
Provider Name | Dr. Clifford Tsuyoshi Baker |
First Address | Sun City, AZ 85351-3032 |
Second Address | Sun City, AZ 85351-3032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 10/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
506835 | (05) | AZ |