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NPI Code Detail

MEDICARE: WOOSUNG AHN, M.D., INC

MEDICARE: WOOSUNG AHN, M.D., INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianA51408CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285766253
Entity Type Code : Organization
Provider Name (Legal Business Name) : WOOSUNG AHN, M.D., INC
Provider Business Mailing Address
First Line : 20145 PIONEER BLVD
Second Line :
City : LAKEWOOD
State : CA
Zip : 90715-1051
Country : US
Telephone Number : 562-916-5020
Fax Number : 562-916-5022
Provider Business Practice Location Address
First Line : 20145 PIONEER BLVD
Second Line :
City : LAKEWOOD
State : CA
Zip : 90715-1051
Country : US
Telephone Number : 562-916-5020
Fax Number : 562-916-5022
Authorized Official
Title or Position : PRESIDENT
Name : WOOSUNG AHN
Credential : M.D.
Telephone Number : 562-916-5020
Provider Enumeration Date : 03/12/2007
Last Update Date : 06/21/2018

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Directions to “WOOSUNG AHN, M.D., INC ” Practice Location

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