Titus Luke Baker, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

License

098639276 Issued in TN

Practice address

2695 Shoup Dr
San Diego, CA 92110-4268

Phone

(931) 335-9190

NPI assigned

Apr 21, 2017

Last updated

Apr 21, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492732800000",
    "number": "1386179810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 SHOUP DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104268",
            "telephone_number": "931-335-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2695 SHOUP DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104268",
            "telephone_number": "931-335-9190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "TITUS",
        "middle_name": "LUKE",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-21",
        "last_updated": "2017-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "TN",
            "license": "098639276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Isaac Baker
• Tanya E. Baker, NP
• Tate Baker, CMT, RYT
• Teauna Rashana Baker
• Thomas Anthony Baker
• Travis L. Baker, DO
• Victoria Baker
• ZH'Naia Baker
• Ashley Asal Bakhadj, DPT
• Omid Reza Bakhtar, M.D.

• Independent Duty Corpsman in San Diego, CA
• Providers in San Diego, CA by specialty
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.