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General NPI Number Information
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NPI Number | 1598977068
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Entity Type | Organization
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Legal Business Name | BALDWIN MEDICAL GROUP
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2100 ARROWHEAD DR
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City | OAKLAND
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State | CA
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Zip | 94611-1558
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Country | US
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Telephone | 510-339-3918
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Fax |
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Provider Business Mailing Address
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Address Line | 433 ESTUDILLO AVE STE.209
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City | SAN LEANDRO
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State | CA
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Zip | 94577-4915
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Country | US
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Telephone | 510-357-3690
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. VINCENT L BALDWIN
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Credential | M.D.
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Telephone | 510-357-3690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G50519
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License Number State | CA
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