MEDICARE: DR. CLYDE GREGORY BAKER 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	207L00000X	Anesthesiology Physician	260746	NY
2	207L00000X	Anesthesiology Physician	C199874	CA

General Provider Information

NPI Number	:	1992970602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLYDE GREGORY BAKER MD

Provider Business Mailing Address
First Line	:	DEPT 354 PO BOX 509015
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92150-9015
Country	:	US
Telephone Number	:	800-406-4558
Fax Number	:	706-653-1162

Provider Business Practice Location Address
First Line	:	1150 N INDIAN CANYON DR
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-4872
Country	:	US
Telephone Number	:	760-323-6511
Fax Number	:	706-653-1162

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

Provider Enumeration Date	:	04/23/2008
Last Update Date	:	12/03/2025

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