Healthcare Provider Details

I. General information

NPI: 1952557878
Provider Name (Legal Business Name): DR CHARLES BAIK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2008
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 W LA VETA AVE STE 109
ORANGE CA
92868-4447
US

IV. Provider business mailing address

705 W LA VETA AVE STE 109
ORANGE CA
92868-4447
US

V. Phone/Fax

Practice location:
  • Phone: 714-832-7212
  • Fax: 714-832-7212
Mailing address:
  • Phone: 714-832-7212
  • Fax: 714-832-7212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE4583
License Number StateCA

VIII. Authorized Official

Name: CHARLES CHULHO BAIK
Title or Position: OWNER
Credential:
Phone: 714-832-7212