Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | A113335 | CA |
N | 2086S0120X | Pediatric Surgery | 2017024332 | MO |
NPI | 1245499896 |
---|---|
Provider Name | Jeong S Hyun |
First Address | Ypsilanti, MI 48197-1014 |
Second Address | Palo Alto, CA 94304-1601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2008 |
Last Update Date | 07/10/2020 |