| |
255 S Hill St Suite 207 Los Angeles CA 90012-3500 | |
(213) 633-4777 | |
(213) 633-4778 |
Full Name | |
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Speciality | Internal Medicine |
Location | 255 S Hill St, Los Angeles, California |
Authorized Official Name and Position | David D Sohn (PRESIDENT) |
Authorized Official Contact | 2134544740 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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255 S Hill St Suite 207 Los Angeles CA 90012-3500 Ph: (213) 633-4777 | 255 S Hill St Suite 207 Los Angeles CA 90012-3500 Ph: (213) 633-4777 |
NPI Number | 1205385408 |
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Provider Enumeration Date | 09/28/2016 |
Last Update Date | 04/12/2017 |
Medicare PECOS PAC ID | 0345528626 |
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Medicare Enrollment ID | O20161021000770 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205385408 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | A133491 (California) | Primary |
Provider Name | David Dai Han Sohn |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1518388008 PECOS PAC ID: 9739467002 Enrollment ID: I20161021000651 |
Provider Name | Elisa Park |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1477931186 PECOS PAC ID: 4880942457 Enrollment ID: I20200817001340 |
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