Baca, Edwin L

Baca, Edwin L is an individual health care provider with primary practice located at 4323 Integrity Center Pt , Colorado Springs CO 80917-1683. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Occupational Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Baca, Edwin L can be contacted via phone (719) 591-2558.

Contact Information

Primary practice address
4323 Integrity Center Pt Colorado Springs CO 80917-1683
Fax: (719) 591-2596
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Occupational Medicine 2083X0100X 45333 Colorado
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X DR.0045333 Colorado

Profile Details

NPI number 1902025935
LBN Legal business name Baca, Edwin L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2007
Last updated Jul 28th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902025935 NPPES
Colorado MEDICAID 70036586

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