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NPI Code Detail

MEDICARE: REBECCA BAE PA-C

MEDICARE: REBECCA BAE PA-C
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
1363A00000XPhysician Assistant0110-005460VA

General Provider Information

NPI Number : 1659827939
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA BAE PA-C
Provider Business Mailing Address
First Line : 5000 MONUMENT AVE FL 2
Second Line :
City : RICHMOND
State : VA
Zip : 23230-3627
Country : US
Telephone Number : 804-269-8291
Fax Number : 804-269-8293
Provider Business Practice Location Address
First Line : 5000 MONUMENT AVE FL 2
Second Line :
City : RICHMOND
State : VA
Zip : 23230-3627
Country : US
Telephone Number : 804-269-8291
Fax Number : 804-269-8293
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2016
Last Update Date : 08/23/2024

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Directions to “ REBECCA BAE PA-C” Practice Location

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