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Gerardo Baltierra
Military Health Care Provider in Baldwin Park, California
NPI 1710457429

Gerardo Baltierra is a Military Health Care Provider based in Baldwin Park, CA. Gerardo Baltierra practices in Baldwin Park, CA. The NPI Number for Gerardo Baltierra is 1710457429 and holds a License No. (California).

The current practice location address for Gerardo Baltierra is 13177 Ramona Blvd, Baldwin Park, CA and can be reached out via phone at 626-337-3828.

Location: 13177 Ramona Blvd, Baldwin Park, CA, 91706-2857
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1710457429
Provider Name
Gerardo Baltierra
Credential
Provider Entity Type
Individual
Gender
Male
Address
13177 Ramona Blvd, Baldwin Park, CA, 91706-2857
Phone Number
626-337-3828
Fax Number
Provider Enumeration Date
11/26/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
98534377E47284 05 CA
D8491732 01 CA DRIVER'S LICENSE
institution
Provider Business Practice Location Address Details
Address
13177 Ramona Blvd
City
Baldwin Park
State
California
Zip
91706-3855
Phone Number
626-337-3828
Fax Number
person
Provider Business Mailing Address Details
Address
13177 Ramona Blvd
City
Baldwin Park
State
California
Zip
91706-3855
Phone Number
626-337-3828
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
()
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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