Provider Demographics
NPI:1497764989
Name:BAIK, JENNIFER J (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:J
Last Name:BAIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:J
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 S HOBART BLVD
Mailing Address - Street 2:SUITE301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-3635
Mailing Address - Country:US
Mailing Address - Phone:213-385-9090
Mailing Address - Fax:213-385-4728
Practice Address - Street 1:300 S HOBART BLVD
Practice Address - Street 2:SUITE301
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-3635
Practice Address - Country:US
Practice Address - Phone:213-385-9090
Practice Address - Fax:213-385-4728
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49466207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF96655Medicare UPIN