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General NPI Number Information
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NPI Number | 1376238592
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Entity Type | Organization
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Legal Business Name | SUNGMIN GROUP USA, INC
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Dates
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Enumeration Date | 04/05/2023
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 809 S HOBART BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90005-2702
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Country | US
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Telephone | 213-385-3304
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Fax | 213-487-2640
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Provider Business Mailing Address
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Address Line | 809 S HOBART BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90005-2702
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Country | US
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Telephone | 213-385-3304
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALEXANDER YOUNG SOO SEO
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Credential | LAC, PHD
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Telephone | 213-385-3304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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