MEDICARE: BEVERLYN BAER

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	171400000X	Health & Wellness Coach	AAC39B3788	CA

General Provider Information

NPI Number	:	1710865050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEVERLYN BAER

Provider Business Mailing Address
First Line	:	2262 MARKET ST APT 3
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92102-2990
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1405 PARK BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-4722
Country	:	US
Telephone Number	:	619-560-4610
Fax Number	:

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

Provider Enumeration Date	:	08/25/2025
Last Update Date	:	08/25/2025

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Directions to “ BEVERLYN BAER ” Practice Location

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