Bae, Susan
Bae, Susan is an individual health care provider with primary practice located at 10945 South St Ste 202 , Cerritos CA 90703-5341. She recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as her primary health care specialty. Bae, Susan can be contacted via phone (424) 256-3967.Contact Information
Primary practice address
10945 South St Ste 202
Cerritos CA 90703-5341
Phone: (424) 256-3967
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 100794 | California |
Profile Details
| NPI number | 1427543800 |
|---|---|
| LBN Legal business name | Bae, Susan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2018 |
| Last updated | Jun 20th, 2024 - about last year |
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 | 1427543800 | NPPES |
| California | MEDICAID | 100794 |
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