Individual
EUN KYUNG BAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
903 CRENSHAW BLVD, #301, LOS ANGELES, CA 90019-1964
(323) 939-0840
(323) 939-0850
Mailing address
903 CRENSHAW AVENUE, #301, LOS ANGELES, CA 90019
(323) 939-0840
(323) 949-0850
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT16277
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT16277
CALIFORNIA OCCUPATIONAL THERAPY BOARD
CA
Enumeration date
06/08/2016
Last updated
07/21/2022
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