Kiyoung Bae
Physician Assistant in Camp Humphreys, Pyeongtaek, GYEONGGI-DO. Individual provider (NPI-1).
NPI number1265112593
StatusActive
Last updated in NPPESSep 3, 2026
Details
- NPI
- 1265112593
- Entity type
- Individual (NPI-1)
- Name
- Kiyoung Bae
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 21, 2023
- Certification date
- Sep 3, 2026
- Last updated
- Sep 3, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
Practice location
Aviation Clinic, Bdaach, Building 30304th Floor
Camp Humphreys, Pyeongtaek, GYEONGGI-DO
Korea, Republic of
Phone 657-465-2535
Mailing address
Psc 400 Box 5033Apo, AP
Phone 657-465-2535
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