Healthcare Provider Details

I. General information

NPI: 1801967450
Provider Name (Legal Business Name): PETER CHRISTENSEN BAKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 52ND ST
OAKLAND CA
94609-1809
US

IV. Provider business mailing address

PO BOX 1654
ROSS CA
94957
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3259
  • Fax: 510-450-5822
Mailing address:
  • Phone: 415-455-8535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberG84861
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: