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General NPI Number Information
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NPI Number | 1255020095
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Entity Type | Individual
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Provider Name | ALEX KIWOOK SUNG PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 05/08/2023
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 7755 CENTER AVE
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-3007
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Country | US
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Telephone | 714-372-2207
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Fax |
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Provider Business Mailing Address
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Address Line | 13311 KILKENNY CT UNIT 205
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City | LA MIRADA
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State | CA
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Zip | 90638-6296
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Country | US
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Telephone | 909-247-6339
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PT303748
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License Number State | CA
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