Provider Demographics
NPI:1124031232
Name:CHOUNG, BAEK YOUNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:BAEK
Middle Name:YOUNG
Last Name:CHOUNG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8653 FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-4032
Mailing Address - Country:US
Mailing Address - Phone:562-622-0066
Mailing Address - Fax:562-869-7541
Practice Address - Street 1:8653 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-4032
Practice Address - Country:US
Practice Address - Phone:562-622-0066
Practice Address - Fax:562-869-7541
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA467701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice