Provider Demographics
NPI:1588677108
Name:EDWARD BAKER MERCHANT, MD, INC
Entity Type:Organization
Organization Name:EDWARD BAKER MERCHANT, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:BAKER
Authorized Official - Last Name:MERCHANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-795-2226
Mailing Address - Street 1:50 ALESSANDRO PLACE
Mailing Address - Street 2:430
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3170
Mailing Address - Country:US
Mailing Address - Phone:626-795-2226
Mailing Address - Fax:626-795-4770
Practice Address - Street 1:50 ALESSANDRO PLACE
Practice Address - Street 2:430
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3170
Practice Address - Country:US
Practice Address - Phone:626-795-2226
Practice Address - Fax:626-795-4770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG33726Medicare PIN