Healthcare Provider Details

I. General information

NPI: 1215100748
Provider Name (Legal Business Name): BAEK CHIROPRACTIC-ACUPUNCTURE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2008
Last Update Date: 08/02/2022
Certification Date: 08/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9681 GARDEN GROVE BLVD SUITE 101-102
GARDEN GROVE CA
92844-1541
US

IV. Provider business mailing address

9681 GARDEN GROVE BLVD SUITE 101-102
GARDEN GROVE CA
92844-1541
US

V. Phone/Fax

Practice location:
  • Phone: 714-530-7001
  • Fax: 714-530-7261
Mailing address:
  • Phone: 714-530-7001
  • Fax: 714-530-7261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC22627
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC14975
License Number StateCA

VIII. Authorized Official

Name: DR. SHARON SUNGHEE BAEK
Title or Position: OWNER
Credential: D.C., L.AC.
Phone: 714-530-7001