Healthcare Provider Details

I. General information

NPI: 1043238769
Provider Name (Legal Business Name): MOSES HYUN, M.D INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 10/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

966 S WESTERN AVE STE 204
LOS ANGELES CA
90006-1013
US

IV. Provider business mailing address

966 S WESTERN AVE STE 204
LOS ANGELES CA
90006-1013
US

V. Phone/Fax

Practice location:
  • Phone: 323-735-1300
  • Fax: 323-735-6734
Mailing address:
  • Phone: 323-735-1300
  • Fax: 323-735-6734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA40302
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA40302
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA40302
License Number StateCA

VIII. Authorized Official

Name: MOSES HYUN
Title or Position: OWNER, M.D.
Credential: M.D.
Phone: 323-735-1300