Bae, Jung Moon
Bae, Jung Moon is an individual health care provider with primary practice located at 1245 Wilshire Blvd Ste 785 , Los Angeles CA 90017-4881. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nephrology, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Bae, Jung Moon can be contacted via phone (213) 389-3200.Contact Information
Primary practice address
1245 Wilshire Blvd Ste 785
Los Angeles CA 90017-4881
Phone: (213) 389-3200
Fax: (213) 572-0515
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | A45605 | California |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | A45605 | California |
Profile Details
| NPI number | 1124119805 |
|---|---|
| LBN Legal business name | Bae, Jung Moon |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 27th, 2006 |
| Last updated | Apr 11th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124119805 | NPPES |
| California | Other | 00A456050 | BLUE SHIELD |
| California | MEDICAID | 00A456050 | BLUE SHIELD |
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