Individual
DR. KEN BAEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10701 MONTGOMERY BLVD NE STE A, ALBUQUERQUE, NM 87111-3800
(505) 828-0828
Mailing address
10701 MONTGOMERY BLVD NE STE A, ALBUQUERQUE, NM 87111-3800
(505) 828-0828
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
030.0134003
VT
152W00000X
Optometrist
Primary
OPT-2024-0010
NM
152W00000X
Optometrist
OPT.0004065
CO
Other
Enumeration date
06/05/2024
Last updated
09/11/2024
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