Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jae Gon Bae

Individual provider Nuclear Medicine Technology Radiologic Technologist · NPI 1275072100

Jae Gon Bae is a Nuclear Medicine Technology Radiologic Technologist in San Diego, California. Licensed in California and Florida. Registered with an NPI since 2017.

Licensed in
CA, FL
In the registry since
2017
Specialties on file
2

Practice location Address checks out

4440 Twain Ave Apt 277
San Diego, CA 92120-3478
Phone: (954) 393-9732
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nuclear Medicine Technology Radiologic Technologist (primary) Taxonomy 2471N0900X · Licence RHN00004203 (CA)
Nuclear Medicine Technology Radiologic Technologist Taxonomy 2471N0900X · Licence CRT89082 (FL)

Record details

NPI number1275072100
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 12, 2017
Last updated in NPPESApril 6, 2021
Certification dateApril 6, 2021
Mailing address4440 Twain Ave Apt 277, San Diego, CA 92120-3478