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Individual

DR. GARY MARK BARON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
8340 W MCDOWELL RD, PHOENIX, AZ 85037-4101
(623) 936-0613
(623) 936-0653
Mailing address
9132 W HEBER RD, TOLLESON, AZ 85353-5563
(714) 394-1387

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
12497TPA
CA
152W00000X
Optometrist
1343
AZ
152W00000X
Optometrist
Primary
P659A
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12497TPA
OPTOMETRY LICENSE NUMBER
CA
01
1343
OPTOMETRY LICENSE NUMBER
AZ
01
P659A
THERAPEUTIC DRUG LICENSE
AZ
Enumeration date
02/08/2007
Last updated
01/31/2014
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