MEDICARE: DR. TANIA MARIA BAKER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	38643	CA

General Provider Information

NPI Number	:	1073720850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TANIA MARIA BAKER DDS

Provider Business Mailing Address
First Line	:	4937 LAS VIRGENES RD
Second Line	:	SUITE 203
City	:	CALABASAS
State	:	CA
Zip	:	91302-2949
Country	:	US
Telephone Number	:	818-880-5520
Fax Number	:	818-880-5355

Provider Business Practice Location Address
First Line	:	4937 LAS VIRGENES RD
Second Line	:	SUITE 203
City	:	CALABASAS
State	:	CA
Zip	:	91302-2949
Country	:	US
Telephone Number	:	818-880-5520
Fax Number	:	818-880-5355

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	07/08/2007

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