STACY FULLER BAECKER PA-C NPI 1043543473

NPI Information

NPI: 1043543473
Provider Name: STACY FULLER BAECKER, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
200 W ARBOR DR
SAN DIEGO, CA
ZIP 92103
Phone: (619) 543-6886
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Stacy Fuller Baecker, PA-C is a surgical physician assistant in San Diego, CA. Stacy Fuller Baecker, PA-C NPI is 1043543473. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

200 W ARBOR DR
SAN DIEGO, CA
ZIP 92103-000
Phone: (619) 543-6886

The NPI 1043543473 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/17/2009 and was last updated on 9/19/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	1089187	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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