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:
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Health care specialties

SpecialtyCodeLicense #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 2 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922090513 NPPES
Arizona MEDICAID 633207

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