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Individual

CHAEWON BAE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1040 S MOUNT VERNON AVE STE E, COLTON, CA 92324-4228
(909) 222-4884
Mailing address
25233 SHEPARDSON DR APT 4, LOMA LINDA, CA 92354-2925
(951) 772-2641

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
89560
CA

Other

Enumeration date
05/15/2024
Last updated
05/15/2024
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