Provider Demographics
NPI:1841343902
Name:PERSONAL HEALTH CARE & CONSULTING, P.A.
Entity type:Organization
Organization Name:PERSONAL HEALTH CARE & CONSULTING, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONGHO
Authorized Official - Middle Name:
Authorized Official - Last Name:BAAG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-584-4853
Mailing Address - Street 1:406 SUBURBAN DR # 112
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-3564
Mailing Address - Country:US
Mailing Address - Phone:302-584-4853
Mailing Address - Fax:302-397-2900
Practice Address - Street 1:9 OKLAHOMA STATE DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-1142
Practice Address - Country:US
Practice Address - Phone:302-584-4853
Practice Address - Fax:302-397-2900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10005050261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1942242557OtherPHYSICIAN NPI
DEH01985Medicare UPIN