Provider Demographics
NPI:1912270893
Name:BAIK, ESTHER JUWON
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:JUWON
Last Name:BAIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 N WESTERN AVE
Mailing Address - Street 2:#9
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-3281
Mailing Address - Country:US
Mailing Address - Phone:323-962-7449
Mailing Address - Fax:323-962-7449
Practice Address - Street 1:901 N WESTERN AVE
Practice Address - Street 2:#9
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-3281
Practice Address - Country:US
Practice Address - Phone:323-962-7449
Practice Address - Fax:323-962-7449
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9469171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist