| Baseline Medical Clinic, Inc | |
|
330 N D St Ste 300 San Bernardino CA 92401-1522 | |
| (909) 888-6602 | |
| (909) 885-7494 |
| Full Name | Baseline Medical Clinic, Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 330 N D St Ste 300, San Bernardino, California |
| Authorized Official Name and Position | Hoang-chuong N Vu (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9098886602 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Baseline Medical Clinic, Inc 330 N D St Ste 300 San Bernardino CA 92401-1522 Ph: (909) 888-6602 | Baseline Medical Clinic, Inc 330 N D St Ste 300 San Bernardino CA 92401-1522 Ph: (909) 888-6602 |
| NPI Number | 1891862553 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 11/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891862553 | NPI | - | NPPES |
| GR0017240 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | C27156 (California) | Primary |
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