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1619390630
JI SEON BAE
CARSON, CA
NPI
1619390630
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 23263)
Enumeration Date
2014-01-27
Last Update Date
2014-01-27
Business Address
-- JI SEON BAE
23517 MAIN ST STE 103
CARSON, CA 90745-5234
Phone number: 562-889-8787
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Mailing Address
-- JI SEON BAE
5830 BONFAIR AVE
LAKEWOOD, CA 90712-1120
Phone number: 562-889-8787
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