Joshua Bae, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC12071 Issued in CA

Practice address

14642 Newport Ave.
#105
Tustin, CA 92780

Phone

(323) 735-5011

Fax

(323) 735-5630

NPI assigned

Jun 23, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sang Suk Bae Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1689835530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14642 NEWPORT AVE.",
            "address_2": "#105",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "92780",
            "telephone_number": "323-735-5011",
            "fax_number": "323-735-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14642 NEWPORT AVE.",
            "address_2": "#105",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "92780",
            "telephone_number": "323-735-5011",
            "fax_number": "323-735-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAE",
        "first_name": "JOSHUA",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC12071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AC12071",
            "identifier": "AC12071",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANG SUK",
            "last_name": "BAE",
            "credential": "L.AC.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ezz Azzeh, DDS, CERT., DMSC
• Gage Logan Babbitt
• Karen Babel, MD
• Robert Frank Bader, MD
• Shannon Marie Badger
• Young Kun Bae, PH.D., L.AC.
• Brendan Baer
• Tomas M Bagaybagayan
• Judi Lynn Bagley, LMFT
• Nalinie Bais

• Acupuncturist in Tustin, CA
• Providers in Tustin, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.