Ji Seon Bae
Nurse Practitioner, Family in Carson, CA. Individual provider (NPI-1).
NPI number1619390630
StatusActive
Last updated in NPPESJan 27, 2014
Details
- NPI
- 1619390630
- Entity type
- Individual (NPI-1)
- Name
- Ji Seon Bae
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 27, 2014
- Last updated
- Jan 27, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 23263 | CA | Yes |
Practice location
23517 Main St Ste 103Carson, CA 90745-5234
Phone 562-889-8787
Mailing address
5830 Bonfair AveLakewood, CA 90712-1120
Phone 562-889-8787
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