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Individual

ZACHERY CHAD BAXTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1260 15TH ST STE 1200, SANTA MONICA, CA 90404
(310) 451-8751
(310) 394-5302
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631

Taxonomy

Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
A103187
CA
208800000X
Urology Physician
Primary
A103187
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0A1031870
CA
Enumeration date
05/03/2007
Last updated
11/26/2019
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