Healthcare Provider Details

I. General information

NPI: 1174688774
Provider Name (Legal Business Name): ROSELINE DAUPHIN BAPTISTE MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 W ALAMEDA AVE STE 424
BURBANK CA
91505-4818
US

IV. Provider business mailing address

254 N LAKE AVE STE 235
PASADENA CA
91101-1829
US

V. Phone/Fax

Practice location:
  • Phone: 877-282-3364
  • Fax: 877-297-4486
Mailing address:
  • Phone: 877-282-3364
  • Fax: 877-297-4486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG55469
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberG55469
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberG55469
License Number StateCA

VIII. Authorized Official

Name: DR. ROSELINE M DAUPHIN BAPTISTE
Title or Position: PHYSICIAN /PRESIDENT
Credential: MD
Phone: 877-282-3364