DR. JONGIL BAE (NPI# 1588002257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588002257 |
| Entity Type | Individual |
| Full Name | DR. JONGIL BAE |
| Credential | D.C. |
| Practice Address |
1201 S Beach Blvd Ste 107 La Habra CA 90631-6366 |
| Mailing Address |
905 S Idaho St Apt 105 La Habra CA 90631-6669 |
| Practice Telephone | 5629021223 |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2013-06-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 32639 | CA | Chiropractic Providers |
| Street Address |
1201 S BEACH BLVD STE 107 |
| City | LA HABRA |
| State | CA |
| Zip Code | 90631-6366 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689202541 | Imperial Clinic | Chiropractor | 1201 S Beach Blvd Ste 107, La Habra, CA 90631-6366 | 2020-03-27 |
| 1992267546 | Hj Lee Chiropractic Corporation | Chiropractor | 1201 S Beach Blvd Ste 107, La Habra, CA 90631-6366 | 2019-04-03 |
| 1205393683 | Hyeong Ju Lee | Chiropractor | 1201 S Beach Blvd Ste 107, La Habra, CA 90631-6366 | 2019-02-21 |
| 1881014603 | Jason Kim | Acupuncturist | 1201 S Beach Blvd Ste 107, La Habra, CA 90631-6366 | 2014-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174163323 | Knowledge of Autism & Other Developmental Disabilities, LLC. | Assistant Behavior Analyst | 890 Whitebook Drive, La Habra, CA 90631 | 2020-01-15 |
| 1215572417 | Anthony Alonzo Favot | Physician Assistant | 2500 Sidon Ave., La Habra, CA 90631 | 2019-11-12 |
| 1487123618 | Adrian Acosta Dds A Prof Dental Corp | Dentist | 901 W. Whittier Blvd, La Habra, CA 90631 | 2018-11-16 |
| 1669961587 | La Habra Villa, LLC | Assisted Living Facility | 1100 E.whittier Blvd, La Habra, CA 90631 | 2018-05-07 |
| 1679089767 | Alicia Igarta | Behavioral Analyst | 890 Whitebook Dr, La Habra, CA 90631 | 2017-12-27 |
| 1609386564 | Antoinette Marie Burgonio | Counselor | 820 Buena Vista Ave, La Habra, CA 90631 | 2017-10-05 |
| 1023527710 | Sharon Rose Stines | Counselor | 271 W. Imperial Hwy, Suite C, La Habra, CA 90631 | 2017-09-25 |
| 1275050999 | Ivan Andro Simunovic | Physician Assistant | 1341 Brookdale Ave., La Habra, CA 90631 | 2017-08-23 |
| 1730609645 | Lorraine Danielle Granado | Specialist/Technologist | 2301 Las Palomas Dr, La Habra Heights, CA 90631 | 2017-06-21 |
| 1649717844 | Marzieh Simonton | Nurse Practitioner | 921 Donnybrook Ave, La Habra, CA 90631 | 2017-01-25 |
| Find all providers in zip 90631 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053763987 | Hyungmin Jun | Chiropractor | 731 N Beach Blvd Ste 140, La Habra, CA 90631-3689 | 2016-07-03 |
| 1245693076 | Teresa Shallow | Chiropractor | 736 W 4th Ave, La Habra, CA 90631-6012 | 2016-03-30 |
| 1023385184 | Kristine A. Lukens | Chiropractor | 2303 W Whittier Blvd, La Habra, CA 90631-3407 | 2011-11-17 |
| 1114230216 | Santana Injury Center | Chiropractor | 860 E La Habra Blvd, Suite 120, La Habra, CA 90631-5532 | 2010-07-16 |
| 1568649846 | Daryoush Amini | Chiropractor | 2290 W Whittier Blvd Ste C, La Habra, CA 90631-3449 | 2008-01-29 |
| 1184813966 | Ronald James Mathis | Chiropractor | 2415 W Whittier Blvd, La Habra, CA 90631-3406 | 2007-10-17 |
| 1750501185 | Norma Denise Franco | Chiropractor | 2661 W Whittier Blvd Ste A, La Habra, CA 90631-3448 | 2007-04-26 |
| 1689703423 | Wayne Ira Walburn | Chiropractor | 1281 E La Habra Blvd, Suite 3, La Habra, CA 90631-5600 | 2007-03-05 |
| 1437296928 | Ki B Park | Chiropractor | 1201 S. Beach Blvd, Suite 107, La Habra, CA 90631 | 2007-01-31 |
| 1639226277 | Robert C. Hughes | Chiropractor | 211 S Euclid St, La Habra, CA 90631-5410 | 2007-01-05 |
| Find all providers in LA HABRA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.