JAE GON BAE NPI 1275072100

NPI Information

  • NPI: 1275072100
  • Provider Name: JAE GON BAE
  • Classification: Radiologic Technologist - 2471N0900X
  • Specialization: Nuclear Medicine Technology
  • Entity Type: Individual
  • Address: 4440 TWAIN AVE APT 277
    SAN DIEGO, CA
    ZIP 92120
  • Phone: (954) 393-9732

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NPI Details

Jae Gon Bae is a nuclear medicine technology radiologic technologist in San Diego, CA. The provider is a radiologic technologist who specializes in nuclear medicine technology and is appropriately educated and trained, consistent with nationally recognized standards, state statute, and facility policy in performance of nuclear medicine imaging, administration of radiopharmaceuticals to patients, exam techniques, equipment protocols, radiation safety, and patient care. Jae Gon Bae NPI is 1275072100. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4440 TWAIN AVE APT 277
SAN DIEGO, CA
ZIP 92120-478
Phone: (954) 393-9732

The enumeration date for this NPI number is 2/12/2017 and was last updated on 4/6/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12471N0900XRadiologic TechnologistNuclear Medicine TechnologyRHN00004203CALIFORNIAYes
22471N0900XRadiologic TechnologistNuclear Medicine TechnologyCRT89082FLORIDANo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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