| Dr Ethan Baughman, MD PHD | |
|
32144 Agoura Rd Ste 220, Westlake Village, CA 91361-4057 | |
| (805) 409-7537 | |
| (310) 363-7610 |
| Full Name | Dr Ethan Baughman |
|---|---|
| Gender | Male |
| Speciality | Plastic And Reconstructive Surgery |
| Experience | 13 Years |
| Location | 32144 Agoura Rd Ste 220, Westlake Village, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619316783 | NPI | - | NPPES |
| 200062362 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208200000X | Plastic Surgery | 2013020089 (Missouri) | Secondary |
| 208200000X | Plastic Surgery | A158793 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Los Robles Hospital & Medical Center | Thousand oaks, CA | Hospital |
| Entity Name | Grossman Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518916311 PECOS PAC ID: 8729090295 Enrollment ID: O20060627000168 |
| Entity Name | Ethan J Baughman Md Inc A Medical Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770050460 PECOS PAC ID: 8325370232 Enrollment ID: O20191025002225 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ethan Baughman, MD PHD 32144 Agoura Rd Ste 220, Westlake Village, CA 91361-4057 Ph: (805) 409-7537 | Dr Ethan Baughman, MD PHD 32144 Agoura Rd Ste 220, Westlake Village, CA 91361-4057 Ph: (805) 409-7537 |
Dr. Jennifer Stark, D.O. Plastic Surgery Medicare: Not Enrolled in Medicare Practice Location: 4373 Park Terrace Dr Unit 101, Westlake Village, CA 91361 Phone: 805-449-7204 | |
Michael Robert Schwartz, MD Plastic Surgery Medicare: Medicare Enrolled Practice Location: 696 Hampshire Road, Suite 210, Westlake Village, CA 91361 Phone: 805-449-7204 Fax: 805-830-0436 |