Organization
BASELINE MEDICAL CLINIC, INC
Active
Other names
Baseline Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
HOANG-CHUONG N VU M.D. (MEDICAL DIRECTOR)
(909) 888-6602
Entity
Organization
Contact information
Practice address
330 N D ST STE 300, SAN BERNARDINO, CA 92401-1522
(909) 888-6602
(909) 885-7494
Mailing address
330 N D ST STE 300, SAN BERNARDINO, CA 92401-1522
(909) 888-6602
(909) 888-6619
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
C27156
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0017240
—
CA
Enumeration date
11/29/2006
Last updated
11/28/2017
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