Provider Demographics
NPI:1386725919
Name:HELEN BAE CHIROPRACTIC
Entity type:Organization
Organization Name:HELEN BAE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:SOUNGYEON
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:BAE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:510-381-3561
Mailing Address - Street 1:15550 ROCKFIELD BLVD
Mailing Address - Street 2:B220
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2720
Mailing Address - Country:US
Mailing Address - Phone:949-598-9999
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:1790 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-5424
Practice Address - Country:US
Practice Address - Phone:510-381-3561
Practice Address - Fax:408-626-7365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26180111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0261800OtherBLUE SHIELD
CAU80111Medicare UPIN
CADC0261800Medicare ID - Type Unspecified