Healthcare Provider Details

I. General information

NPI: 1619086840
Provider Name (Legal Business Name): SUE JUNG RHEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUE FLAHIVE M.D.

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/04/2023
Certification Date: 08/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PARNASSUS AVE MU4E BOX 0136
SAN FRANCISCO CA
94143-0001
US

IV. Provider business mailing address

1635 DIVISADERO ST SUITE 625, BOX 1821
SAN FRANCISCO CA
94143-0001
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-5892
  • Fax: 415-476-1343
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA93038
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberA93038
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2080T0004X
TaxonomyPediatric Transplant Hepatology Physician
License NumberA93038
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: