Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | A132195 | CA |
NPI | 1003172529 |
---|---|
Provider Name | Sangmee Bae |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-6932 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2012 |
Last Update Date | 04/12/2019 |