Bakke Medical PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

4301037608 Issued in MI

Legal business name

BAKKE MEDICAL PC

Practice address

1039 Washington St
Dearborn, MI 48124-2016

Phone

(313) 563-1033

Fax

(313) 563-2930

NPI assigned

Feb 16, 2007

Last updated

Feb 14, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Daisy S Angeles, MDNPI 1073512752

Title

President

Phone

(313) 563-1033

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daisy S Angeles, MD

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1073512752
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550102400000",
    "number": "1265576888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21723 GARRISON ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242368",
            "telephone_number": "313-274-4215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 WASHINGTON ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242016",
            "telephone_number": "313-563-1033",
            "fax_number": "313-563-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAKKE MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2019-02-14",
        "status": "A",
        "authorized_official_last_name": "ANGELES",
        "authorized_official_first_name": "DAISY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-563-1033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "4301037608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1361633",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rashard Dajuan Baker
• Samantha Baker, OTRL
• Tiffany Baker
• Christopher Bakerjian
• Arsala Bakhtyar, M.D.
• Ibtissam Ahmed Balaa
• Magdalena Balan, CNP
• Jacob Balash, DPT, PT
• Pradeep Balasubramanian, M.D.
• Ali Balawi

• Clinic/Center in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.