Provider Demographics
NPI:1508036625
Name:BAEKS CHIROPRACTIC HEALTH CENTER
Entity Type:Organization
Organization Name:BAEKS CHIROPRACTIC HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:S
Authorized Official - Last Name:BAEK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:909-548-6868
Mailing Address - Street 1:13801 ROSWELL AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-5466
Mailing Address - Country:US
Mailing Address - Phone:909-548-6868
Mailing Address - Fax:909-548-6855
Practice Address - Street 1:13801 ROSWELL AVE
Practice Address - Street 2:SUITE G
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-5466
Practice Address - Country:US
Practice Address - Phone:909-548-6868
Practice Address - Fax:909-548-6855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27581111NS0005X
CAAC9447171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1962583633OtherNPI
CA1962512137OtherNPI