Healthcare Provider Details

I. General information

NPI: 1427113034
Provider Name (Legal Business Name): MARI K BALDWIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UC SAN DIEGO DEPT. OF ANESTHESIOLOGY 200 WEST ARBOR DR. MC 0801
SAN DIEGO CA
92103
US

IV. Provider business mailing address

4021 FALCON ST #311
SAN DIEGO CA
92103-1883
US

V. Phone/Fax

Practice location:
  • Phone: 619-543-5720
  • Fax:
Mailing address:
  • Phone: 619-795-3862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA77658
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA77658
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: