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General NPI Number Information
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NPI Number | 1942712526
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Entity Type | Organization
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Legal Business Name | SUNDO HAM, DDS. INC.
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Dates
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Enumeration Date | 11/03/2017
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Last Update Date | 11/03/2017
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Provider Practice Location Address
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Address Line | 711 S VERMONT AVE STE 111
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City | LOS ANGELES
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State | CA
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Zip | 90005-1587
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Country | US
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Telephone | 213-387-2325
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Fax | 213-387-0910
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Provider Business Mailing Address
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Address Line | 711 S VERMONT AVE STE 111
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City | LOS ANGELES
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State | CA
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Zip | 90005-1587
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Country | US
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Telephone | 213-387-2325
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Fax | 213-387-0910
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SUJIN YU
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Credential |
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Telephone | 213-369-5330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 62031
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License Number State | CA
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