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General NPI Number Information
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NPI Number | 1417423898
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Entity Type | Organization
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Legal Business Name | CHRISTINA BAEK, DDS, PC
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Dates
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Enumeration Date | 10/23/2018
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Last Update Date | 10/23/2018
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Provider Practice Location Address
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Address Line | 3605 HOSPITAL RD
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City | ATWATER
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State | CA
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Zip | 95301-5173
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Country | US
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Telephone | 818-515-9447
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Fax |
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Provider Business Mailing Address
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Address Line | 18960 VENTURA BLVD # 74
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City | TARZANA
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State | CA
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Zip | 91356-3224
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTINA BAEK
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Credential |
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Telephone | 818-515-9447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number |
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License Number State |
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