Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | G041345 | CA |
NPI | 1093821639 |
---|---|
Provider Name | Robert Arnold Baker |
First Address | San Diego, CA 92103-2723 |
Second Address | San Diego, CA 92103-2723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 08/07/2007 |