Healthcare Provider Details

I. General information

NPI: 1023945607
Provider Name (Legal Business Name): MAURICE JAMES BAKER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 WORLEY RD
SUISUN CITY CA
94585-1935
US

IV. Provider business mailing address

1300 WORLEY RD
SUISUN CITY CA
94585-1935
US

V. Phone/Fax

Practice location:
  • Phone: 707-563-7779
  • Fax:
Mailing address:
  • Phone: 707-563-7779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberCPT-02159928
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: