Provider Demographics
NPI:1881689347
Name:BARON, DICRAN B (MD)
Entity Type:Individual
Prefix:DR
First Name:DICRAN
Middle Name:B
Last Name:BARON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:705 W LA VETA AVE
Mailing Address - Street 2:#112
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4402
Mailing Address - Country:US
Mailing Address - Phone:714-744-1529
Mailing Address - Fax:714-744-1102
Practice Address - Street 1:705 W LA VETA AVE
Practice Address - Street 2:#112
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4402
Practice Address - Country:US
Practice Address - Phone:714-744-1529
Practice Address - Fax:714-744-1102
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG40050207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G400500Medicaid
A89696Medicare UPIN
CA00G400500Medicaid