Provider Demographics
NPI:1093811077
Name:BAE, DAVID KIM (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KIM
Last Name:BAE
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:17074 CAMINO CABRILLO
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-6200
Mailing Address - Country:US
Mailing Address - Phone:714-792-0924
Mailing Address - Fax:714-792-0924
Practice Address - Street 1:301 W HUNTINGTON DR
Practice Address - Street 2:SUITE 300
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-3462
Practice Address - Country:US
Practice Address - Phone:626-821-9323
Practice Address - Fax:626-821-9325
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2021-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAE3962213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist