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General NPI Number Information
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NPI Number | 1700057924
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Entity Type | Organization
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Legal Business Name | JIMMY BAE CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 03/15/2008
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Last Update Date | 03/15/2008
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Provider Practice Location Address
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Address Line | 266 S HARVARD BLVD SUITE 210
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City | LOS ANGELES
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State | CA
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Zip | 90004-4372
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Country | US
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Telephone | 213-382-0560
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Fax |
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Provider Business Mailing Address
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Address Line | 266 S HARVARD BLVD SUITE 210
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City | LOS ANGELES
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State | CA
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Zip | 90004-4372
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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 | DR. JIMMY BAE
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Credential | D.C.
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Telephone | 213-382-0560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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