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General NPI Number Information
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NPI Number | 1255597951
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Entity Type | Individual
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Provider Name | SANG YOUN O D.O
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Gender | Male
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Dates
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Enumeration Date | 08/01/2008
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 645 E MISSOURI AVE STE 300
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City | PHOENIX
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State | AZ
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Zip | 85012-1351
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Country | US
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Telephone | 602-262-8917
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Fax | 602-262-8890
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Provider Business Mailing Address
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Address Line | 2810 N SWAN RD SUITE 100
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City | TUCSON
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State | AZ
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Zip | 85712-6305
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Country | US
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Telephone | 520-324-2030
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Fax | 520-445-6019
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 4817
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License Number State | AZ
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