Provider Demographics
NPI:1295318780
Name:BAKER, STEPHANIE PAOLA (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:PAOLA
Last Name:BAKER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 DEEP VALLEY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3749
Mailing Address - Country:US
Mailing Address - Phone:310-547-4692
Mailing Address - Fax:310-265-4780
Practice Address - Street 1:602 DEEP VALLEY DR STE 300
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3749
Practice Address - Country:US
Practice Address - Phone:310-547-4692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA191808207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine