Healthcare Provider Details

I. General information

NPI: 1982000717
Provider Name (Legal Business Name): CLARIBEL BAISA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLARIBEL BAISA MEDICAL ASSISTANT

II. Dates (important events)

Enumeration Date: 11/05/2014
Last Update Date: 11/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2608 CENTRAL AVE STE 1
UNION CITY CA
94587-3148
US

IV. Provider business mailing address

15921 VIA CONEJO
SAN LORENZO CA
94580-2338
US

V. Phone/Fax

Practice location:
  • Phone: 510-675-0600
  • Fax: 510-675-0185
Mailing address:
  • Phone: 510-590-0434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: