Provider Demographics
NPI:1295398931
Name:BAKER OPTOMETRY, INC.
Entity Type:Organization
Organization Name:BAKER OPTOMETRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:530-756-5050
Mailing Address - Street 1:2019 ANDERSON RD STE C
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-0773
Mailing Address - Country:US
Mailing Address - Phone:530-756-5050
Mailing Address - Fax:530-204-5995
Practice Address - Street 1:2019 ANDERSON RD STE C
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-0773
Practice Address - Country:US
Practice Address - Phone:530-756-5050
Practice Address - Fax:530-204-5995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty