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General NPI Number Information
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NPI Number | 1295265171
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Entity Type | Individual
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Provider Name | MIN BAHK PT, ATC
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Gender | Male
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 02/05/2023
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Provider Practice Location Address
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Address Line | 249 S LA FAYETTE PARK PL APT 304
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City | LOS ANGELES
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State | CA
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Zip | 90057-1337
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Country | US
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Telephone | 213-926-8930
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Fax |
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Provider Business Mailing Address
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Address Line | 249 S LA FAYETTE PARK PL APT 304
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City | LOS ANGELES
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State | CA
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Zip | 90057-1337
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Country | US
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Telephone | 213-926-8930
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 51391
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2000027143
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1372257
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License Number State | TX
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