Provider Demographics
NPI:1770709479
Name:BAUMGARTNER, STEVE (PT)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:BAUMGARTNER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24355 LYONS AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2300
Mailing Address - Country:US
Mailing Address - Phone:661-290-2884
Mailing Address - Fax:
Practice Address - Street 1:24355 LYONS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-2300
Practice Address - Country:US
Practice Address - Phone:661-290-2884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT19906225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT19906AMedicare PIN
CAS39021Medicare UPIN