Healthcare Provider Details

I. General information

NPI: 1134117955
Provider Name (Legal Business Name): CHAD MICHAEL BAASEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 01/31/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL CAMP PENDLETON 200 MERCY CIRCLE
OCEANSIDE CA
92055
US

IV. Provider business mailing address

NAVAL HOSPITAL CAMP PENDLETON 200 MERCY CIRCLE
OCEANSIDE CA
92055
US

V. Phone/Fax

Practice location:
  • Phone: 760-719-3337
  • Fax:
Mailing address:
  • Phone: 760-719-3337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberM001471
License Number StateGU
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA64062
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: