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General NPI Number Information
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NPI Number | 1689651135
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Entity Type | Individual
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Provider Name | KENNETH Y BAIK MD
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Gender | Male
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1175 E ARROW HWY STE D
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City | UPLAND
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State | CA
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Zip | 91786-5525
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Country | US
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Telephone | 909-920-3753
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Fax | 909-920-0875
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Provider Business Mailing Address
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Address Line | 1175 E ARROW HWY STE D
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City | UPLAND
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State | CA
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Zip | 91786-5525
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Country | US
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Telephone | 909-920-3753
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Fax | 909-920-0875
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | C42999
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License Number State | CA
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