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General NPI Number Information
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NPI Number | 1104835404
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Entity Type | Individual
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Provider Name | RONALD PAUL BAUMGARTNER P.A.
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/16/2012
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Provider Practice Location Address
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Address Line | 231 W PARKWOOD AVE
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City | LA HABRA
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State | CA
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Zip | 90631-7222
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Country | US
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Telephone | 562-360-7591
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Fax | 213-626-2512
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Provider Business Mailing Address
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Address Line | 231 W PARKWOOD AVE
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City | LA HABRA
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State | CA
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Zip | 90631-7222
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Country | US
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Telephone | 562-360-7591
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | PA 13047
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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