Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 128239 | CA |
NPI | 1043411887 |
---|---|
Provider Name | Jennifer Sung |
First Address | Mission Hills, CA 91346-9602 |
Second Address | Valencia, CA 91355-4462 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 03/12/2021 |