Provider Demographics
NPI:1942757521
Name:BAKER, MADEEHA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:MADEEHA
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74785 SAN CRISTOVAL CIRCLE
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-9458
Mailing Address - Country:US
Mailing Address - Phone:734-846-4475
Mailing Address - Fax:
Practice Address - Street 1:74785 SAN CRISTOVAL CIR
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-3146
Practice Address - Country:US
Practice Address - Phone:734-846-4475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA733831835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care