DR. JOHN B BAK (NPI# 1063413938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063413938 |
| Entity Type | Individual |
| Full Name | DR. JOHN B BAK |
| Credential | M.D. |
| Practice Address |
11307 Bridgeport Way Sw Ste 217 Lakewood WA 98499-3024 |
| Practice Telephone | 2539856134 |
| Practice Fax Number | 2539856137 |
| Mailing Telephone | 2539856134 |
| Mailing Fax Number | 2539856137 |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2012-11-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | MD00044997 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7077449 | 05 | |
| WA | STATE L&I | 0216025 | 01 |
| WA | STATE L&I | 0299315 | 01 |
| WA | STATE L&I | 0261681 | 01 |
| WA | STATE L&I | 0261684 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558898825 | John Bak | Student in an Organized Health Care Education/Training Program | 1 University of New Mexico Msc 10 5610, Albuquerque, NM 87131-0001 | 2017-05-17 |
| 1235770702 | John Richard Bak Jr. | Nurse Practitioner | 700 High St, Williamsport, PA 17701-3100 | 2019-10-04 |
| Street Address |
11307 BRIDGEPORT WAY SW STE 217 |
| City | LAKEWOOD |
| State | WA |
| Zip Code | 98499-3024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275159592 | Sea Mar Community Health Centers | Clinic/Center | 5700 100th Street Se, Suite 510, Lakewood, WA 98499 | 2020-06-23 |
| 1568018828 | Heather Leigh Andrade | Behavioral Analyst | 6210 75th St W Ste 100, Lakewood, WA 98499 | 2019-08-13 |
| 1043870876 | Seoul Chinese Herbs Inc | Acupuncturist | 8705 S. Tacoma Way, Lakewood, WA 98499 | 2019-06-14 |
| 1013572064 | Puget Sound Kidney Centers | Clinic/Center | 11950 47th Ave Sw, Lakewood, WA 98499 | 2019-05-06 |
| 1447736657 | Marcela Cunan | Counselor | 9330 59th Avenue Southest, Lakewood, WA 98499 | 2018-07-11 |
| 1609382381 | Leroy Moore IIi | Counselor | 8811 S. Tacoma Way, 106, Lakewood, WA 98499 | 2017-12-18 |
| 1578077657 | Andrea Gaston | Behavior Technician | 8815 S. Tacoma Way, Suite 122, Lakewood, WA 98499 | 2017-11-27 |
| 1609389931 | Jennifer King | Social Worker | 5900 100th St Sw Ste 17b, Lakewood, WA 98499 | 2017-11-08 |
| 1750806337 | Wonyoung Lee | Counselor | 8811 South Tacoma Way, Suite 106, Lakewood, WA 98499 | 2017-08-04 |
| 1043749443 | Frederick Paltron Edwards | Counselor | 9500 Front Street, Suite 100, Lakewood, WA 98499 | 2017-06-08 |
| Find all providers in zip 98499 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164507356 | Nand S Datta | Urology | 5750 Downey Avenue, Suite #100, Lakewood, CA 90712 | 2006-10-26 |
| 1417976705 | Greater Long Beach Genito-urinary Med Grp | Urology | 3650 South Street, Suite 408, Lakewood, CA 90712-1510 | 2006-07-18 |
| 1679559603 | Lawrence Robert Vidrine | Urology | 11367 Bridgeport Way Sw, Suite 217, Lakewood, WA 98499-3004 | 2005-12-21 |
| 1144212598 | Kiritkumar M Pandya | Urology | 101 Prospect St, St#101, Lakewood, NJ 08701-5020 | 2005-08-20 |
| 1003147869 | Franciscan Medical Group | Urology | 11307 Bridgeport Way Sw, Suite 217, Lakewood, WA 98499-3024 | 2010-01-19 |
| 1811162555 | William M Zurich Jr Md Imrt LLC | Urology | 900 Route 70 East, Lakewood, NJ 08701-5940 | 2008-04-24 |
| 1215023940 | Lakewood Surgical Urology Ps | Urology | 11306 Bridgeport Way Sw, Suite D, Lakewood, WA 98499-3005 | 2006-10-04 |
| 1316959125 | Associated Urologists LLC | Urology | 1255 Highway 70, Suite 33s, Lakewood, NJ 08701-5900 | 2006-08-12 |
| 1437181286 | Franciscan Medical Group | Urology | 11307 Bridgeport Way Sw, Ste 217, Lakewood, WA 98499-3024 | 2006-07-06 |
| 1356370167 | Jay Winemiller | Urology | 11307 Bridgeport Way Sw, Ste 217, Lakewood, WA 98499-3024 | 2006-07-02 |
| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.