Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | DO1783 | NV |
NPI | 1558643155 |
---|---|
Provider Name | Dr. Robert Baker |
First Address | Pasadena, CA 91199-0001 |
Second Address | Henderson, NV 89014-8800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2011 |
Last Update Date | 27/10/2020 |