Provider Demographics
NPI:1689650772
Name:KINDY-BAILLOT, NADINE ALEXANDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:NADINE
Middle Name:ALEXANDRA
Last Name:KINDY-BAILLOT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NADINE
Other - Middle Name:ALEXANDRA
Other - Last Name:KINDY-DEGNAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2222 EAST STREET
Mailing Address - Street 2:SUITE 365
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2056
Mailing Address - Country:US
Mailing Address - Phone:925-687-8280
Mailing Address - Fax:925-687-9744
Practice Address - Street 1:2222 EAST STREET
Practice Address - Street 2:SUITE 365
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2056
Practice Address - Country:US
Practice Address - Phone:925-687-8280
Practice Address - Fax:925-687-9744
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG60632207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G606321Medicaid
CA00G606325Medicare ID - Type Unspecified
F00631Medicare UPIN