Healthcare Provider Details

I. General information

NPI: 1881689347
Provider Name (Legal Business Name): DICRAN B BARON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 01/04/2022
Certification Date: 01/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 W LA VETA AVE #112
ORANGE CA
92868-4402
US

IV. Provider business mailing address

705 W LA VETA AVE #112
ORANGE CA
92868-4402
US

V. Phone/Fax

Practice location:
  • Phone: 714-744-1529
  • Fax: 714-744-1102
Mailing address:
  • Phone: 714-744-1529
  • Fax: 714-744-1102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberG40050
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG40050
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: