MEDICARE: MR. PETER UNGJO BAIK D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	007606	AZ
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	CL0446	NV

General Provider Information

NPI Number	:	1003063173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PETER UNGJO BAIK D.O.

Provider Business Mailing Address
First Line	:	1155 MILL ST # M14
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89502-1576
Country	:	US
Telephone Number	:	775-982-6270
Fax Number	:	775-982-6271

Provider Business Practice Location Address
First Line	:	75 PRINGLE WAY STE 900
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89502-1464
Country	:	US
Telephone Number	:	775-982-6270
Fax Number	:	775-982-6271

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2008
Last Update Date	:	01/28/2026

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