Provider Demographics
NPI:1346283926
Name:BAKER, BRUCE RONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:RONALD
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2114 DIVISADERO ST.
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2127
Mailing Address - Country:US
Mailing Address - Phone:415-922-4094
Mailing Address - Fax:415-346-8170
Practice Address - Street 1:2114 DIVISADERO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2127
Practice Address - Country:US
Practice Address - Phone:415-922-4094
Practice Address - Fax:415-346-8170
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG986402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry