| Baag, Lee & Chung Dental Corp. | |
|
3224 W Olympic Blvd # 201 Los Angeles CA 90006-2317 | |
| (323) 737-1001 | |
| Not Available |
| Full Name | Baag, Lee & Chung Dental Corp. |
|---|---|
| Speciality | Clinic/Center |
| Location | 3224 W Olympic Blvd # 201, Los Angeles, California |
| Authorized Official Name and Position | Jin Ho Lee (PRESIDENT) |
| Authorized Official Contact | 3237371001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baag, Lee & Chung Dental Corp. 3224 W Olympic Blvd # 201 Los Angeles CA 90006-2317 Ph: (323) 737-1001 | Baag, Lee & Chung Dental Corp. 3224 W Olympic Blvd # 201 Los Angeles CA 90006-2317 Ph: (323) 737-1001 |
| NPI Number | 1437793445 |
|---|---|
| Provider Enumeration Date | 11/01/2019 |
| Last Update Date | 11/01/2019 |
| Medicare PECOS PAC ID | 3577992817 |
|---|---|
| Medicare Enrollment ID | O20200702001045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437793445 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Jin Ho Lee |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1366618811 PECOS PAC ID: 4981034345 Enrollment ID: I20200430002522 |
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