Individual
GERALD G BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1260 15TH ST, SUITE 1014, SANTA MONICA, CA 90404-1135
(310) 451-1618
(310) 395-6747
Mailing address
1260 15TH ST, SUITE 1014, SANTA MONICA, CA 90404-1135
(310) 451-1618
(310) 395-6747
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
E1735
CA
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
E1735
CA
213ER0200X
Radiology Podiatrist
E1735
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
E1735
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0207250001
MEDICARE DME
CA
01
—
1043245525
GROUP NPI
CA
01
—
E1735
STATE LICENSE NUMBER
CA
01
—
WE6504
MEDICARE GROUP NUMBER
CA
Enumeration date
05/09/2007
Last updated
01/18/2011
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