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6705 Old York Rd Philadelphia PA 19126-2841 | |
| (215) 224-2000 | |
| (215) 224-8651 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 6705 Old York Rd, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | George Jung Soo Choe (CHAIRMAN) |
| Authorized Official Contact | 2152242000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
6705 Old York Rd Philadelphia PA 19126-2841 Ph: (215) 224-2000 | 6705 Old York Rd Philadelphia PA 19126-2841 Ph: (215) 224-2000 |
| NPI Number | 1366498479 |
|---|---|
| Provider Enumeration Date | 05/26/2006 |
| Last Update Date | 03/28/2023 |
| Medicare PECOS PAC ID | 8729061742 |
|---|---|
| Medicare Enrollment ID | O20040610001240 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366498479 | NPI | - | NPPES |
| 0007340700003 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jennifer Jin-kyung Suh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558356477 PECOS PAC ID: 0749227288 Enrollment ID: I20050415000137 |
| Provider Name | Inkyo Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821069717 PECOS PAC ID: 6204926256 Enrollment ID: I20071214000393 |
| Provider Name | Won M Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437199502 PECOS PAC ID: 0446444004 Enrollment ID: I20101028000408 |
| Provider Name | Young N Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902866510 PECOS PAC ID: 9638355431 Enrollment ID: I20110511000816 |
| Provider Name | Sunwha Hong |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659319168 PECOS PAC ID: 7113194937 Enrollment ID: I20120119000480 |
| Provider Name | Su Jung Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295005049 PECOS PAC ID: 0547401523 Enrollment ID: I20141016001855 |
| Provider Name | Jamie Paik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588975163 PECOS PAC ID: 4981845369 Enrollment ID: I20151008002072 |
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