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General NPI Number Information
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NPI Number | 1790839256
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Entity Type | Individual
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Provider Name | DR. LINDA H BAEK
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Gender | Female
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 255 N GILBERT ST C2
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City | HEMET
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State | CA
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Zip | 92543
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Country | US
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Telephone | 951-766-4211
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Fax | 951-766-4210
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Provider Business Mailing Address
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Address Line | 25661 HURON ST
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City | LOMA UNDA
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State | CA
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Zip | 92354
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Country | US
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Telephone | 909-528-1321
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 52711
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License Number State | CA
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