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General NPI Number Information
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NPI Number | 1285844001
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Entity Type | Organization
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Legal Business Name | RICHARD W. BAKER, O.D.
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 04/15/2009
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Provider Practice Location Address
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Address Line | 3581 MT DIABLO BLVD
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City | LAFAYETTE
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State | CA
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Zip | 94549-3891
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Country | US
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Telephone | 925-283-8502
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Fax |
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Provider Business Mailing Address
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Address Line | 3581 MT DIABLO BLVD
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City | LAFAYETTE
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State | CA
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Zip | 94549-3891
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Country | US
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Telephone | 925-283-8502
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD W. BAKER
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Credential | O.D.
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Telephone | 925-283-8502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4640TPG
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License Number State | CA
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