Individual
TIMOTHY J BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCP
Contact information
Practice address
15239 PORTICO LN, FONTANA, CA 92336-1021
(909) 740-4114
(909) 591-8343
Mailing address
15239 PORTICO LN, FONTANA, CA 92336-1021
(909) 740-4114
(909) 591-8343
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
NONE
—
Other
Enumeration date
12/07/2010
Last updated
12/07/2010
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