Provider Demographics
NPI:1447937560
Name:ALYSE MICHELE BARON MD INC
Entity type:Organization
Organization Name:ALYSE MICHELE BARON MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALYSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-668-2525
Mailing Address - Street 1:1190 BAKER ST STE 103
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-4105
Mailing Address - Country:US
Mailing Address - Phone:714-668-2525
Mailing Address - Fax:714-668-2530
Practice Address - Street 1:1190 BAKER ST STE 103
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4105
Practice Address - Country:US
Practice Address - Phone:714-668-2525
Practice Address - Fax:714-668-2530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty