Provider Demographics
NPI:1942314083
Name:BARON AND BARON MEDICAL CORPORATION
Entity Type:Organization
Organization Name:BARON AND BARON MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-351-4848
Mailing Address - Street 1:PO BOX 7096
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95267-0096
Mailing Address - Country:US
Mailing Address - Phone:209-956-7725
Mailing Address - Fax:209-956-7733
Practice Address - Street 1:751 W. LEGION ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-7755
Practice Address - Country:US
Practice Address - Phone:760-351-4848
Practice Address - Fax:760-351-4849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG26743208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G267430Medicaid
CAWG26743DOtherMEDICARE PPIN
CAW20349Medicare PIN
CAA43086Medicare UPIN