Bae, Soungwon
Bae, Soungwon is an individual health care provider with primary practice located at 9348 E Rita Rd Ste 100 , Tucson AZ 85747-6313. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Bae, Soungwon can be contacted via phone (520) 324-4760.Contact Information
Primary practice address
9348 E Rita Rd Ste 100
Tucson AZ 85747-6313
Phone: (520) 324-4760
Fax: (520) 324-4759
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 3706 | Arizona |
Profile Details
| NPI number | 1922090513 |
|---|---|
| LBN Legal business name | Bae, Soungwon |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 18th, 2005 |
| Last updated | Jun 13th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922090513 | NPPES |
| Arizona | MEDICAID | 633207 |
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