Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 054382 | NY |
Y | 122300000X | Dentist | 64108 | CA |
N | 204E00000X | Oral & Maxillofacial Surgeon | 253116 | NY |
N | 204E00000X | Oral & Maxillofacial Surgeon | A103815 | CA |
NPI | 1376796433 |
---|---|
Provider Name | Dr. James S Sunwoo |
First Address | West Hollywood, CA 90069-7563 |
Second Address | West Hollywood, CA 90069-7563 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2008 |
Last Update Date | 02/07/2015 |