Individual provider · NPI-1

Wanjun Bae, M.D.

Internal Medicine, Gastroenterology · Mission Viejo, CA

NPI number1457433906
StatusActive
Last updated in NPPESOct 26, 2020

Details

NPI
1457433906
Entity type
Individual (NPI-1)
Name
Wanjun Bae
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Oct 20, 2006
Certification date
Oct 26, 2020
Last updated
Oct 26, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207RG0100X Internal Medicine, GastroenterologyA85159CAYes
207R00000X Internal MedicineA85159CA

Practice location

27871 Medical Center Rd Ste 200
Mission Viejo, CA 92691-6406

Phone 949-364-5090 · Fax 949-364-5427

Mailing address

27871 Medical Center Rd Ste 200
Mission Viejo, CA 92691-6406

Phone 949-364-5090 · Fax 949-364-5427

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