Healthcare Provider Details

I. General information

NPI: 1447660154
Provider Name (Legal Business Name): STEVEN ANDREW BAKER M.D. PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2014
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR RM L235
STANFORD CA
94305-2200
US

IV. Provider business mailing address

1735 WOODLAND AVE APT 61
E PALO ALTO CA
94303-2325
US

V. Phone/Fax

Practice location:
  • Phone: 650-493-5000
  • Fax:
Mailing address:
  • Phone: 904-962-4471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberA139005
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number12366425-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: