Active NPI
Austin Baek
- Pharmacist
- Granite Bay, CA
National Provider Identifier
1205299294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 71702
- Practice address
- 4080 Douglas Blvd
Granite Bay, CA 95746-5900 - Phone
- (916) 380-3262
- NPI assigned
- Mar 29, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 71702 | CA | Primary |
Addresses
Primary practice location
4080 Douglas Blvd
Granite Bay, CA 95746-5900
Mailing address
8282 Calvine Rd
Unit 3075
Sacramento, CA 95828-9314
Phone (213) 254-7452
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71702 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Eastvale, CA
- NPI 1770458945
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459209600000",
"number": "1205299294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8282 CALVINE RD",
"address_2": "UNIT 3075",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958289314",
"telephone_number": "213-254-7452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4080 DOUGLAS BLVD",
"city": "GRANITE BAY",
"state": "CA",
"postal_code": "957465900",
"telephone_number": "916-380-3262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAEK",
"first_name": "AUSTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-29",
"last_updated": "2016-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "71702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granite Bay, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.