Steven Suk Bong Bae, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

11602T Issued in CA

Practice address

1110 S Western Ave Ste 202
Los Angeles, CA 90006-2680

Phone

(323) 998-0080

Fax

(323) 857-1001

NPI assigned

May 11, 2006

Last updated

May 2, 2017By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493683200000",
    "number": "1750331526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 S WESTERN AVE STE 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062680",
            "telephone_number": "323-998-0080",
            "fax_number": "323-857-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 S WESTERN AVE STE 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062680",
            "telephone_number": "323-998-0080",
            "fax_number": "323-857-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAE",
        "first_name": "STEVEN",
        "middle_name": "SUK BONG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2017-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11602T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Yoonbum Bae, D.D.S.
• Rachel Hyejung Bae, OTD
• Ryan Bae, DO
• Sangmee Bae, M.D.
• Seoyeong Bae, CASE MANAGER
• Sung Hwan Bae, DPT
• Sunhyung Bae
• Won H Bae, M.D.
• Youra Bae
• Robert Baehner

• Optometrist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; 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.