MEDICARE: DR. STEVE SANG -HYUN KOH M.D

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	2084P0800X	Psychiatry Physician	A103468	CA

General Provider Information

NPI Number	:	1467650473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVE SANG -HYUN KOH M.D

Provider Business Mailing Address
First Line	:	UCSD 9500 GILMAN DR
Second Line	:	MC 0993
City	:	LA JOLLA
State	:	CA
Zip	:	92093-0001
Country	:	US
Telephone Number	:	858-246-0763
Fax Number	:

Provider Business Practice Location Address
First Line	:	UCSD 9500 GILMAN DR
Second Line	:	MC 0993
City	:	LA JOLLA
State	:	CA
Zip	:	92093-0001
Country	:	US
Telephone Number	:	858-246-0763
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2007
Last Update Date	:	08/03/2011

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