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Individual

JASON BAHNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1650 LEAD HILL BLVD STE 100, ROSEVILLE, CA 95661-3072
(832) 376-8600
Mailing address
1650 LEAD HILL BLVD STE 100, ROSEVILLE, CA 95661-3072

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
3160
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E6087
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
T49-2021
TX

Other

Enumeration date
05/06/2019
Last updated
11/06/2024
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