DR. SOUNGWON BAE (NPI# 1922090513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922090513 |
| Entity Type | Individual |
| Full Name | DR. SOUNGWON BAE |
| Credential | DO |
| Practice Address |
630 N Alvernon Way Ste 251 Tucson AZ 85711-1879 |
| Practice Telephone | 5203228460 |
| Practice Fax Number | 5203228210 |
| Mailing Telephone | 5203228460 |
| Mailing Fax Number | 5203228210 |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2019-09-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 3706 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 633207 | 05 |
| Street Address |
630 N ALVERNON WAY STE 251 |
| City | TUCSON |
| State | AZ |
| Zip Code | 85711-1879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104303080 | Shaina Berman | Physician Assistant | 630 N Alvernon Way Ste 251, Tucson, AZ 85711 | 2018-07-24 |
| 1093258964 | Matthew Gilkey | Nurse Practitioner | 630 N Alvernon Way Ste 251, Tucson, AZ 85711-1879 | 2016-11-28 |
| 1023564135 | Jessica Coffey | Nurse Practitioner | 630 N Alvernon Way Ste 251, Tucson, AZ 85711-1879 | 2016-08-29 |
| 1851747166 | Christopher Taylor | Nurse Practitioner | 630 N Alvernon Way Ste 251, Tucson, AZ 85711 | 2016-05-05 |
| 1871851782 | Sukhampal Singh Sidhu | Internal Medicine | 630 N Alvernon Way Ste 251, Tucson, AZ 85711-1879 | 2012-04-27 |
| 1972834984 | Carondelet Medical Group Inc | Podiatrist | 630 N Alvernon Way Ste 251, Tucson, AZ 85711-1879 | 2010-01-15 |
| 1124294756 | Winola Rachel Purushotham | Internal Medicine | 630 N Alvernon Way Ste 251, Tucson, AZ 85711-1879 | 2008-05-04 |
| 1215159322 | Deepa Agarwal | Pediatrics | 630 N Alvernon Way Ste 251, Tucson, AZ 85711-1879 | 2007-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356959951 | Ridgeline Practice | Counselor | 4625 N Broadway, Suite 105, Tucson, AZ 85711 | 2020-07-20 |
| 1881229946 | Famiglia Amore II LLC | Assisted Living Facility | 632 N. Wilmot, Tucson, AZ 85711 | 2020-03-10 |
| 1992343362 | Laurie Anne Mcmahon | Family Medicine | 899 N. Wilmot, Building B, Tucson, AZ 85711 | 2019-12-17 |
| 1063060093 | Sharese Ann Bailey | Counselor | 300 S Craycroft Rd, Tucson, AZ 85711 | 2019-09-03 |
| 1467940015 | Jin Zhang | Ophthalmology | 655 N Alvernon Way Ste 204, Tucson, AZ 85711 | 2018-04-30 |
| 1447779525 | Catherine Butler Hobart | Pharmacist | 535 North Wilmont Road, Suite 101, Tucson, AZ 85711 | 2017-09-11 |
| 1689196420 | Cope Community Services, Inc. | Case Management | 924 N Alvernon Way, Tucson, AZ 85711 | 2017-07-13 |
| 1124561477 | Regina Maendler | Behavioral Analyst | 630 N. Craycroft Rd, Tucson, AZ 85711 | 2016-11-18 |
| 1881140184 | Elleda Linsmeyer | Speech-Language Pathologist | St. Joesph's Hosptial, 350 N. Wilmont Rd., Tucson, AZ 85711 | 2016-08-28 |
| 1962856260 | Csl-tucson, LLC | Assisted Living Facility | 1020 N. Woodland Avenue, Tucson, AZ 85711 | 2016-04-22 |
| Find all providers in zip 85711 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235793100 | Jacquelyn Christine Wagner | Pediatrics | 1625 N Campbell, Tucson, AZ 85719 | 2019-04-26 |
| 1952965212 | Jeremey William Gneck | Pediatrics | 1625 N Campbell Ave Tucson Az 85719, Tucson, AZ 85724-0001 | 2019-04-23 |
| 1992295158 | Melanie Anne Kaplanek | Pediatrics | 1501 N Campbell Ave Rm 3301, Tucson, AZ 85724-0001 | 2018-05-14 |
| 1003352154 | Pleasant Pediatrics Plc | Pediatrics | 1601 N Oracle Rd, Tucson, AZ 85705-6440 | 2017-01-13 |
| 1134570211 | Eryn Simmons | Pediatrics | 1620 W Commerce Ct, Tucson, AZ 85746-6005 | 2016-06-29 |
| 1063860518 | Rachael Charles | Pediatrics | 2621 N Woodland Rd, Tucson, AZ 85749-9576 | 2016-05-25 |
| 1376998294 | Drew Carter Johnson | Pediatrics | 1625 N Campbell Ave Rm 3301, Tucson, AZ 85719-4330 | 2016-04-28 |
| 1609280742 | Emily Nicole Lawson | Pediatrics | 826 W Placita Estrella Azul, Tucson, AZ 85713-1595 | 2014-06-17 |
| 1598184020 | John Paul Jarczyk | Pediatrics | University of Arizona Dept of Pediatrics, 1501 N. Campbell Ave., Tucson, AZ 85724-0001 | 2014-04-11 |
| 1558780346 | Leo Warren Landau Md | Pediatrics | 11702 E Saint James Rd, Tucson, AZ 85748-7928 | 2014-04-09 |
| Find all providers in TUCSON | ||||
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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.