Healthcare Provider Details
I. General information
NPI: 1568481497
Provider Name (Legal Business Name): NAVDEEP SINGH BAATH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/19/2006
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 MAIN STREET
SAN QUENTIN CA
94964-0001
US
IV. Provider business mailing address
795 WILLOW RD
MENLO PARK CA
94025-2539
US
V. Phone/Fax
- Phone: 510-648-4950
- Fax:
- Phone: 650-493-5000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | A88305 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: