Provider Demographics
NPI:1316518681
Name:ELIZA SUKHEE AHN MD INC
Entity type:Organization
Organization Name:ELIZA SUKHEE AHN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZA
Authorized Official - Middle Name:SUKHEE
Authorized Official - Last Name:AHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:747-800-7454
Mailing Address - Street 1:15243 VANOWEN ST STE 311
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-3653
Mailing Address - Country:US
Mailing Address - Phone:747-800-7454
Mailing Address - Fax:747-264-0433
Practice Address - Street 1:15243 VANOWEN ST STE 311
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-3653
Practice Address - Country:US
Practice Address - Phone:747-800-7454
Practice Address - Fax:747-264-0433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty