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NPI Code Detail

MEDICARE: DR. SUN WOONG OH MD

MEDICARE: DR. SUN WOONG OH MD
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
1207L00000XAnesthesiology PhysicianC53641CA
2207L00000XAnesthesiology PhysicianD0020653MD

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 : 1578527651
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUN WOONG OH MD
Provider Business Mailing Address
First Line : 201 OCEAN AVE
Second Line : UNIT 1605P
City : SANTA MONICA
State : CA
Zip : 90402-1415
Country : US
Telephone Number : 410-370-0154
Fax Number :
Provider Business Practice Location Address
First Line : 1300 N VERMONT AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90027-6098
Country : US
Telephone Number : 213-413-3000
Fax Number : 323-666-2939
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2006
Last Update Date : 05/05/2017

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Directions to “ DR. SUN WOONG OH MD” Practice Location

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