Provider Demographics
NPI:1144319609
Name:BAGGOT, PATRICK JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JAMES
Last Name:BAGGOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PADDY
Other - Middle Name:JIM
Other - Last Name:BAGGOT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3020 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 219
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-1120
Mailing Address - Country:US
Mailing Address - Phone:213-386-2606
Mailing Address - Fax:213-386-2603
Practice Address - Street 1:3020 WILSHIRE BLVD
Practice Address - Street 2:SUITE 219
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-1120
Practice Address - Country:US
Practice Address - Phone:213-386-2606
Practice Address - Fax:213-386-2603
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG84916207V00000X, 207SG0201X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G849160Medicaid
CAWG84916BOtherMEDICARE
CA00G849160Medicaid
CAWG84916BOtherMEDICARE