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General NPI Number Information
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NPI Number | 1134383284
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Entity Type | Organization
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Legal Business Name | SOPHIA S. HOM, MD, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 09/15/2008
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Provider Practice Location Address
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Address Line | 1245 WILSHIRE BOULVARD SUITE 804
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City | LOS ANGELES
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State | CA
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Zip | 90017-4810
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Country | US
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Telephone | 213-482-1725
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Fax | 213-482-1725
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Provider Business Mailing Address
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Address Line | 616 ST PAUL AVE SUITE 732
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City | LOS ANGELES
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State | CA
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Zip | 90017-2022
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Country | US
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Telephone | 213-482-1725
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SOPHIA SUNG HOM
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Credential | MD
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Telephone | 213-482-1725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | G70336
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License Number State | CA
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