| Baek Primary Clinic Llc | |
|
11275 E Mississippi Ave Ste 1e8 Aurora CO 80012-2818 | |
| (646) 552-1862 | |
| Not Available |
| Full Name | Baek Primary Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11275 E Mississippi Ave Ste 1e8, Aurora, Colorado |
| Authorized Official Name and Position | Sujin Baek (NP) |
| Authorized Official Contact | 6465521862 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baek Primary Clinic Llc 1439 S Emporia Ct Aurora CO 80247-7347 Ph: (646) 552-1862 | Baek Primary Clinic Llc 11275 E Mississippi Ave Ste 1e8 Aurora CO 80012-2818 Ph: (646) 552-1862 |
| NPI Number | 1467214221 |
|---|---|
| Provider Enumeration Date | 01/26/2024 |
| Last Update Date | 01/26/2024 |
| Medicare PECOS PAC ID | 0042656407 |
|---|---|
| Medicare Enrollment ID | O20240308000390 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467214221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Sujin Baek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831626423 PECOS PAC ID: 2961839261 Enrollment ID: I20240308001391 |
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