Provider Demographics
NPI:1861776122
Name:OH, SUNG W (LAC)
Entity type:Individual
Prefix:MR
First Name:SUNG
Middle Name:W
Last Name:OH
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2975 WILSHIRE BLVD
Mailing Address - Street 2:# 603
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-1107
Mailing Address - Country:US
Mailing Address - Phone:213-380-5878
Mailing Address - Fax:
Practice Address - Street 1:2975 WILSHIRE BLVD
Practice Address - Street 2:# 603
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-1107
Practice Address - Country:US
Practice Address - Phone:213-380-5878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 7094171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist