Provider Demographics
NPI:1881889137
Name:BAER, JOSHUA CHAD (OD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:CHAD
Last Name:BAER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 COLLINGSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-6218
Mailing Address - Country:US
Mailing Address - Phone:714-326-5339
Mailing Address - Fax:
Practice Address - Street 1:3840 EL DORADO HILLS BLVD STE 103
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-4567
Practice Address - Country:US
Practice Address - Phone:916-618-4832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 13368152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist