Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A159983 | CA |
Y | 208600000X | Surgeon | A159983 | CA |
N | 2086S0122X | Plastic and Reconstructive Surgery | A159983 | CA |
NPI | 1124361803 |
---|---|
Provider Name | Ji Hye Son |
First Address | Whittier, CA 90602-1049 |
Second Address | Whittier, CA 90602-1049 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2013 |
Last Update Date | 07/02/2022 |