Provider Demographics
NPI:1912214685
Name:JENNIFER BARON, MD, A MEDICAL CORPORATION
Entity type:Organization
Organization Name:JENNIFER BARON, MD, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:AHIMSA
Authorized Official - Last Name:BARON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-310-6060
Mailing Address - Street 1:123 DI SALVO AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1717
Mailing Address - Country:US
Mailing Address - Phone:408-418-8780
Mailing Address - Fax:408-297-2659
Practice Address - Street 1:143 RINCONADA AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-3726
Practice Address - Country:US
Practice Address - Phone:415-310-6060
Practice Address - Fax:408-297-2659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-01
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92659261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical