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NPI Code Detail

MEDICARE: SUNG SON FNP-C

MEDICARE: SUNG SON FNP-C
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
1363LF0000XFamily Nurse PractitionerAP8224AZ

General Provider Information

NPI Number : 1437522489
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUNG SON FNP-C
Provider Business Mailing Address
First Line : 16160 S 50TH ST APT 203
Second Line :
City : PHOENIX
State : AZ
Zip : 85048-0455
Country : US
Telephone Number : 480-321-5227
Fax Number :
Provider Business Practice Location Address
First Line : 4430 E RAY RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85044-6092
Country : US
Telephone Number : 180-038-9272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2015
Last Update Date : 06/06/2016

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Directions to “ SUNG SON FNP-C” Practice Location

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