Provider Demographics
NPI:1316106339
Name:YOM, SUNG MI (OD)
Entity type:Individual
Prefix:DR
First Name:SUNG
Middle Name:MI
Last Name:YOM
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:3240 WILSHIRE BLVD STE 112A
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-1502
Mailing Address - Country:US
Mailing Address - Phone:847-372-4527
Mailing Address - Fax:213-427-3537
Practice Address - Street 1:3240 WILSHIRE BLVD STE 112A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-1502
Practice Address - Country:US
Practice Address - Phone:847-372-4527
Practice Address - Fax:213-427-3537
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA4663152W00000X
CA13613T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist