MEDICARE: SOHN PLASTIC SURGERY, P.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
1	2086S0122X	Plastic and Reconstructive Surgery Physician	12434	NV

General Provider Information

NPI Number	:	1447419734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOHN PLASTIC SURGERY, P.C.

Provider Business Mailing Address
First Line	:	5876 S PECOS RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3418
Country	:	US
Telephone Number	:	702-733-1333
Fax Number	:

Provider Business Practice Location Address
First Line	:	5876 S PECOS RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3418
Country	:	US
Telephone Number	:	702-733-1333
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SAMUEL MYUNGJIN SOHN
Credential	:
Telephone Number	:	310-913-4165

Provider Enumeration Date	:	06/03/2008
Last Update Date	:	06/03/2008

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