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NPI Code Detail

MEDICARE: DR. KISMET BALDWIN M.D.

MEDICARE: DR. KISMET BALDWIN M.D.
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
1208000000XPediatrics PhysicianP21929MD
22080N0001XNeonatal-Perinatal Medicine Physician16893NH
32083P0901XPublic Health & General Preventive Medicine PhysicianA111522CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760674527
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KISMET BALDWIN M.D.
Provider Business Mailing Address
First Line : 1601 E HAZELTON AVE
Second Line :
City : STOCKTON
State : CA
Zip : 95205-6229
Country : US
Telephone Number : 209-468-3411
Fax Number : 209-468-3823
Provider Business Practice Location Address
First Line : 1601 E HAZELTON AVE
Second Line :
City : STOCKTON
State : CA
Zip : 95205-6229
Country : US
Telephone Number : 209-468-3411
Fax Number : 209-468-3823
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2007
Last Update Date : 05/07/2019

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Directions to “ DR. KISMET BALDWIN M.D.” Practice Location

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