Organization
SEONG GON BAE MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEONG GON BAE MD (CEO)
(818) 782-3255
Entity
Organization
Contact information
Practice address
15211 VANOWEN ST UNIT 200, VAN NUYS, CA 91405-3606
(818) 782-3255
(818) 782-7026
Mailing address
230 S JACKSON ST APT 309, GLENDALE, CA 91205-1592
(818) 782-3255
(818) 782-7026
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A123341
CA
Other
Enumeration date
11/02/2013
Last updated
02/10/2022
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