Provider Demographics
NPI:1457352916
Name:BARON, NORMAN E (MD)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:E
Last Name:BARON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG26743208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G267430Medicaid
A43086Medicare UPIN
CAWG26743DMedicare PIN