Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | G84916 | CA |
Y | 207V00000X | Obstetrician & Gynecologist | G84916 | CA |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | G84916 | CA |
NPI | 1144319609 |
---|---|
Provider Name | Dr. Patrick James Baggot |
First Address | Los Angeles, CA 90010-1120 |
Second Address | Los Angeles, CA 90010-1120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 29/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G849160 | (05) | CA |
E21750 | (02) | |
WG84916B | MEDICARE (01) | CA |