Provider Demographics
NPI:1386658326
Name:BARON, STEPHANIE D (PA-C)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:D
Last Name:BARON
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:310 N INDIAN HILL BLVD STE 526
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-4611
Mailing Address - Country:US
Mailing Address - Phone:909-294-7329
Mailing Address - Fax:909-912-8631
Practice Address - Street 1:274 W BADILLO ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1906
Practice Address - Country:US
Practice Address - Phone:626-915-3476
Practice Address - Fax:626-653-1256
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA 17201363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA17201OtherPA LICENSE