Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN0400X | Neurology | DC22627 | CA |
N | 111NR0200X | Radiology | DC22627 | CA |
N | 213ER0200X | Radiology | DC22627 | CA |
N | 111NS0005X | Chiropractic Sports Physician | DC 22627 | CA |
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC22627 | CA |
NPI | 1922022219 |
---|---|
Provider Name | Dr. Sharon Sunghee Baek |
First Address | Garden Grove, CA 92844-1541 |
Second Address | Garden Grove, CA 92844-1541 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 25/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AC 14975 | ACUPUNCTURE (01) | CA |
DC22627 | CHIROPRACTOR (01) | CA |