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General NPI Number Information
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NPI Number | 1659492262
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Entity Type | Organization
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Legal Business Name | RALPH S BAKER,O.D.INC.
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/24/2008
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Provider Practice Location Address
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Address Line | 531 OAK ST SUITE 2
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City | ROSEVILLE
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State | CA
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Zip | 95678-2615
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Country | US
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Telephone | 916-783-8131
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Fax | 916-783-3465
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Provider Business Mailing Address
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Address Line | 531 OAK ST STE 2
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City | ROSEVILLE
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State | CA
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Zip | 95678-2615
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Country | US
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Telephone | 916-783-8131
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Fax | 916-783-3465
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | RALPH SIMON BAKER
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Credential | OD
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Telephone | 916-783-8131
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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 |
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License Number State |
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