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General NPI Number Information
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NPI Number | 1013646157
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Entity Type | Organization
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Legal Business Name | JEFF SUNG, MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 06/06/2022
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Last Update Date | 06/06/2022
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Provider Practice Location Address
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Address Line | 15031 RINALDI ST
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City | MISSION HILLS
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State | CA
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Zip | 91345-1207
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Country | US
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Telephone | 818-496-1837
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Fax |
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Provider Business Mailing Address
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Address Line | 2234 5TH ST
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City | SANTA MONICA
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State | CA
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Zip | 90405-2402
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEFF SUNG
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Credential |
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Telephone | 310-600-0938
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Emergency Medicine) Physician
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License Number |
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License Number State |
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