Provider Demographics
NPI:1093821639
Name:BAKER, ROBERT ARNOLD (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ARNOLD
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 WASHINGTON PL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2723
Mailing Address - Country:US
Mailing Address - Phone:949-259-0463
Mailing Address - Fax:949-259-0463
Practice Address - Street 1:1820 WASHINGTON PL
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2723
Practice Address - Country:US
Practice Address - Phone:949-259-0463
Practice Address - Fax:949-259-0463
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG041345207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine