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Jae Gon Bae
Nuclear Medicine Technology Radiologic Technologist in San Diego, California
NPI 1275072100

Jae Gon Bae is a Nuclear Medicine Technology Radiologic Technologist based in San Diego, CA and is specialized in Nuclear Medicine Technology. Jae Gon Bae practices in San Diego, CA. The NPI Number for Jae Gon Bae is 1275072100 and holds a License No. CRT89082 (California).

The current practice location address for Jae Gon Bae is 4440 Twain Ave Apt 277, San Diego, CA and can be reached out via phone at 954-393-9732.

Location: 4440 Twain Ave Apt 277, San Diego, CA, 92120-3478
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1275072100
Provider Name
Jae Gon Bae
Credential
Provider Entity Type
Individual
Gender
Male
Address
4440 Twain Ave Apt 277, San Diego, CA, 92120-3478
Phone Number
954-393-9732
Fax Number
Provider Enumeration Date
02/12/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4440 Twain Ave Apt 277
City
San Diego
State
California
Zip
92120-3478
Phone Number
954-393-9732
Fax Number
person
Provider Business Mailing Address Details
Address
4440 Twain Ave Apt 277
City
San Diego
State
California
Zip
92120-3478
Phone Number
954-393-9732
Fax Number
person
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Radiologic Technologist
Speciality
Nuclear Medicine Technology
Taxonomy
2471N0900X
License No.
CRT89082 (Florida)
Definition
Definition to come.
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