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General NPI Number Information
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NPI Number | 1326793308
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Entity Type | Individual
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Provider Name | MR. DALLAS S BAKER JR.
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Gender | Male
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Dates
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Enumeration Date | 02/17/2022
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 800 PRESIDIO AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-2921
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Country | US
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Telephone | 415-928-6596
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Fax |
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Provider Business Mailing Address
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Address Line | 2712 MISSION ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-3104
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Country | US
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Telephone | 415-401-2700
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | MPSS-OQFMLG
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License Number State | CA
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