Individual provider · NPI-1

Gordon Hyeonjin Bae, MD

Dermatology · Stanford, CA

NPI number1003265653
StatusActive
Last updated in NPPESApr 16, 2024

Details

NPI
1003265653
Entity type
Individual (NPI-1)
Name
Gordon Hyeonjin Bae
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jun 5, 2016
Certification date
Apr 16, 2024
Last updated
Apr 16, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207N00000X DermatologyA150572CAYes

Practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Phone 650-723-4000

Mailing address

450 Broadway St
Redwood City, CA 94063-3132

Phone 650-723-6316

Other practice locations

75 Francis St
Boston, MA 02115-6110

Phone 617-732-5500

450 Broadway St
Redwood City, CA 94063-3132

Phone 650-723-6316

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