Search › California › 2471N0900X
Jae Gon Bae
NPI 1275072100 · on the registry since 2017
Practice
- Address
- 4440 Twain Ave Apt 277
San Diego, CA 92120 - Phone
- (954) 393-9732
- Organisation at this address
- Evergreen Psychiatry Inc.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- 2471N0900X
2471N0900X
- Also registered as
- 2471N0900X
- Licence states on file
- FL, CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-04-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California