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NPI Code Detail

MEDICARE: DR. SUNG WAN HAM M.D.

MEDICARE:  DR. SUNG WAN HAM  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
1208600000XSurgery PhysicianA103684CA
22086S0129XVascular Surgery PhysicianA103684CA

General Provider Information

NPI Number : 1790929164
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUNG WAN HAM M.D.
Provider Business Mailing Address
First Line : 1050 PACIFIC COAST HWY FL 2
Second Line :
City : HARBOR CITY
State : CA
Zip : 90710-3509
Country : US
Telephone Number : 310-602-7927
Fax Number : 424-328-2634
Provider Business Practice Location Address
First Line : 1050 PACIFIC COAST HWY FL 2
Second Line :
City : HARBOR CITY
State : CA
Zip : 90710-3509
Country : US
Telephone Number : 310-602-7927
Fax Number : 424-328-2634
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2009
Last Update Date : 05/22/2023

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Directions to “ DR. SUNG WAN HAM M.D.” Practice Location

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