Baseline Medical Clinic, Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

C27156 Issued in CA

Legal business name

BASELINE MEDICAL CLINIC, INC

Doing business as

Baseline Medical Clinic

Practice address

330 N D St Ste 300
San Bernardino, CA 92401-1522

Phone

(909) 888-6602

Fax

(909) 885-7494

NPI assigned

Nov 29, 2006

Last updated

Nov 28, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hoang-Chuong N Vu, M.D.

Title

Medical Director

Phone

(909) 888-6602

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Baseline Medical Clinic Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511827200000",
    "number": "1891862553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N D ST STE 300",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011522",
            "telephone_number": "909-888-6602",
            "fax_number": "909-888-6619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N D ST STE 300",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011522",
            "telephone_number": "909-888-6602",
            "fax_number": "909-885-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASELINE MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2017-11-28",
        "status": "A",
        "authorized_official_last_name": "VU",
        "authorized_official_first_name": "HOANG-CHUONG",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "909-888-6602",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "C27156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0017240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baseline Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erick Walter Barthel
• Cortnie Breanne Barton, AMFT
• Elsie Bedolla Barton
• Lauren Barton
• Mary Jocelyn Somera Bascos
• Jennifer Jean Bass, LPT
• Lindsay Danielle Bass, A.A.
• Marshawn Bass
• Vaada Nikole Bass, APRN, PMHNP-BC
• Nyisha Bassett

• Clinic/Center in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.