Individual
DR. JOSE BAEZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1402 S GRAND BLVD # M260, ST. LOUIS UNIVERSITY - GME, SAINT LOUIS, MO 63104-1004
(314) 577-8762
Mailing address
5813 CLEMENS AVE, SAINT LOUIS, MO 63112-2311
(314) 422-9618
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2011011825
MO
207R00000X
Internal Medicine Physician
Primary
A120405
CA
Other
Enumeration date
08/06/2008
Last updated
12/02/2021
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