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General NPI Number Information
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NPI Number | 1336219526
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Entity Type | Individual
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Provider Name | SUNG HWAN BAE DPT
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Gender | Male
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 04/17/2009
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Provider Practice Location Address
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Address Line | 11601 WILSHIRE BLVD STE 105
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City | LOS ANGELES
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State | CA
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Zip | 90025-0509
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Country | US
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Telephone | 310-665-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 6263 POPLAR AVE STE 801
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City | MEMPHIS
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State | TN
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Zip | 38119-4701
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Country | US
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Telephone | 901-685-7227
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Fax | 267-321-2079
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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