MEDICARE: DR. LOC BAO D.D.S.

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	1223G0001X	General Practice Dentistry	44290	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	D44290	OTHER	CA	DENTI-CAL

General Provider Information

NPI Number	:	1770750424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOC BAO D.D.S.

Provider Business Mailing Address
First Line	:	4236 EL CAJON BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92105-1230
Country	:	US
Telephone Number	:	619-584-4015
Fax Number	:	619-584-4016

Provider Business Practice Location Address
First Line	:	4236 EL CAJON BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92105-1230
Country	:	US
Telephone Number	:	619-584-4015
Fax Number	:	619-584-4016

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

Provider Enumeration Date	:	05/13/2008
Last Update Date	:	05/13/2008

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1952308918 — MRS. HIEN T NGUYEN BS PHARMACY
Practice Location Address:

4242 EL CAJON BLVD
SAN DIEGO, CA
92105-1230

Practice Phone: 619-521-0013
Practice Fax: 619-521-1067

1073535621 — MR. KIEM DUC PHAM M.D.
Practice Location Address:

4240 EL CAJON BLVD
SAN DIEGO, CA
92105-1230

Practice Phone: 619-563-6142
Practice Fax: 619-563-0183

1528138039 — LOC BAO, DDS, INC.
Practice Location Address:

4236 EL CAJON BLVD
SAN DIEGO, CA
92105-1230

Practice Phone: 619-584-4015
Practice Fax: 619-584-4016

1821118910 — THE JHC CORPORTATION
Practice Location Address:

4242 EL CAJON BLVD
SAN DIEGO, CA
92105-1230

Practice Phone: 619-521-0013
Practice Fax: 619-521-1067

1174802813 — DR. QUY LAM PHUOC NGUYEN D.D.S.
Practice Location Address:

4236 EL CAJON BLVD
SAN DIEGO, CA
92105-1230

Practice Phone: 619-584-4015
Practice Fax: 619-584-4016

Directions to “ DR. LOC BAO D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.