Healthcare Provider Details

I. General information

NPI: 1003394685
Provider Name (Legal Business Name): JOYHAN JAY SUNG RRT-NPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2018
Last Update Date: 08/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25825 VERMONT AVE
HARBOR CITY CA
90710-3518
US

IV. Provider business mailing address

20335 ANZA AVE APT 13
TORRANCE CA
90503-2349
US

V. Phone/Fax

Practice location:
  • Phone: 310-517-2648
  • Fax:
Mailing address:
  • Phone: 310-489-8031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279P3900X
TaxonomyNeonatal/Pediatric Registered Respiratory Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: