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General NPI Number Information
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NPI Number | 1265613160
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Entity Type | Organization
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Legal Business Name | BAEK Y. CHOUNG, D.D.S., INC
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 8653 FLORENCE AVE
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City | DOWNEY
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State | CA
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Zip | 90240-4032
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Country | US
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Telephone | 562-622-0066
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Fax |
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Provider Business Mailing Address
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Address Line | 8653 FLORENCE AVE
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City | DOWNEY
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State | CA
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Zip | 90240-4032
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Country | US
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Telephone | 562-622-0066
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BAEK YOUNG CHOUNG
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Credential | D.D.S.
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Telephone | 562-622-0066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 46770
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License Number State | CA
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