MEDICARE: DR. STEPHEN ALBERT BAEZ MD

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	207RP1001X	Pulmonary Disease Physician	9615	NV
2	207R00000X	Internal Medicine Physician	9615	NV
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	9615	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11491730	OTHER		CAQH

General Provider Information

NPI Number	:	1851376123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN ALBERT BAEZ MD

Provider Business Mailing Address
First Line	:	1155 MILL ST # MCM14
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89502-1576
Country	:	US
Telephone Number	:	775-982-5262
Fax Number	:	775-982-5496

Provider Business Practice Location Address
First Line	:	1500 E 2ND ST STE 302
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89502-1198
Country	:	US
Telephone Number	:	775-982-5000
Fax Number	:	775-982-3900

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

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	12/15/2020

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