Provider Demographics
NPI:1013231828
Name:BAIK, JOHN CHONGHOON (RN)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CHONGHOON
Last Name:BAIK
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S KINGSLEY DR
Mailing Address - Street 2:APT. #304
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-3268
Mailing Address - Country:US
Mailing Address - Phone:949-932-2440
Mailing Address - Fax:
Practice Address - Street 1:400 S KINGSLEY DR
Practice Address - Street 2:APT. #304
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-3268
Practice Address - Country:US
Practice Address - Phone:949-932-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-23
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA694781163W00000X
CA3981367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse