Healthcare Provider Details

I. General information

NPI: 1770774036
Provider Name (Legal Business Name): RAYMOND PEDRO BAILIE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4793 STATE HIGHWAY 3
BILLINGS MT
59106-9676
US

IV. Provider business mailing address

400 N TUSTIN AVE STE 400
SANTA ANA CA
92705-3850
US

V. Phone/Fax

Practice location:
  • Phone: 406-860-8160
  • Fax:
Mailing address:
  • Phone: 949-689-0723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA99853
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number92750
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA99853
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberMED-PHYS-LIC-50477
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: