Active NPI
Rene Philippe Baquet, PA
- Surgical Physician Assistant
- Azusa, CA
National Provider Identifier
1205928140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA11523
- Practice address
- 223 S Murray Ave
Azusa, CA 91702-4610 - Phone
- (626) 969-4509
- NPI assigned
- Sep 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA11523 | CA | Primary |
Addresses
Primary practice location
223 S Murray Ave
Azusa, CA 91702-4610
Mailing address
PO Box 841
Ca
Azusa, CA 91702-0841
Phone (626) 334-9818
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA11523 | CA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Payam Vahedifar MD Inc | Past | Accepting new patients | |
| Lyg, a Professional Medical Corporation | Orthopaedic Surgery | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Newport Beach, CA
- NPI 1255362406
Orthopaedic Surgery
-
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Encino, CA
- NPI 1710176094
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329091200000",
"number": "1205928140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 841",
"address_2": "CA",
"city": "AZUSA",
"state": "CA",
"postal_code": "917020841",
"telephone_number": "626-334-9818",
"fax_number": "775-249-7634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "223 S MURRAY AVE",
"city": "AZUSA",
"state": "CA",
"postal_code": "917024610",
"telephone_number": "626-969-4509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAQUET",
"first_name": "RENE",
"middle_name": "PHILIPPE",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-29",
"last_updated": "2012-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "CA",
"license": "PA11523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Azusa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.