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NPI Code Detail

MEDICARE: SUNG-NAE BYUN M D MEDICAL GROUP INC

MEDICARE: SUNG-NAE BYUN M D MEDICAL GROUP INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianA61249CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053317834
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNG-NAE BYUN M D MEDICAL GROUP INC
Provider Business Mailing Address
First Line : 2120 W 8TH ST
Second Line : STE 102
City : LOS ANGELES
State : CA
Zip : 90057-4019
Country : US
Telephone Number : 213-382-2700
Fax Number : 213-382-5077
Provider Business Practice Location Address
First Line : 2120 W 8TH ST
Second Line : STE 102
City : LOS ANGELES
State : CA
Zip : 90057-4019
Country : US
Telephone Number : 213-382-2700
Fax Number : 213-382-5077
Authorized Official
Title or Position : CEO
Name : DR. SUNG NAE BYUN
Credential : M.D.
Telephone Number : 213-382-2700
Provider Enumeration Date : 06/26/2005
Last Update Date : 06/15/2015

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