NPIMap

Individual provider Active NPI

Hubert Vance Sung, M.D.

  • Family Medicine Physician
  • Torrance, CA
National Provider Identifier
1861777633
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A129055 Issued in CA
Practice address
21311 Madrona Ave
Suite 100-a
Torrance, CA 90503-5970
Phone
(310) 792-4400
Fax
(310) 542-5805
NPI assigned
Oct 12, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A129055 CA Primary

Addresses

Primary practice location

21311 Madrona Ave
Suite 100-a
Torrance, CA 90503-5970

Mailing address

21311 Madrona Ave
Suite 100-a
Torrance, CA 90503-5970
Phone (310) 792-4400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hsung457107@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140918002713 CA Practitioner - Family Practice 4183843493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

Glendale, CA 91202

21311 Madrona Ave
Torrance, CA 90503-5970

21501 Avalon Blvd
Suite 100
Carson, CA 90745-2210
Phone (310) 835-6627

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A129055CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute Family Medicine Current Accepting new patients
Providence Medical Institute Family Medicine CurrentSince Sep 1, 2014 Accepting new patients
Providence Medical Institute Family Medicine CurrentSince Sep 1, 2014 Accepting new patients

Locations

21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

1010 N Sepulveda Blvd
Manhattan Beach, CA 90266
Phone (310) 322-9700

1499 W 1st St
San Pedro, CA 90732
Phone (310) 241-2590

2382 Crenshaw Blvd
Ste 5
Torrance, CA 90501
Phone (310) 618-6200

21311 Madrona Ave
Ste 100A
Torrance, CA 90503
Phone (310) 792-4400

21311 Madrona Ave
Ste 101
Torrance, CA 90503
Phone (310) 792-4012

21311 Madrona Ave
Ste 100C
Torrance, CA 90503
Phone (310) 792-4444

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1861777633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21311 MADRONA AVE",
            "address_2": "SUITE 100-A",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905035970",
            "telephone_number": "310-792-4400",
            "fax_number": "310-542-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21311 MADRONA AVE",
            "address_2": "SUITE 100-A",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905035970",
            "telephone_number": "310-792-4400",
            "fax_number": "310-542-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNG",
        "first_name": "HUBERT",
        "middle_name": "VANCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-12",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A129055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hsung457107@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "21311 Madrona Ave",
            "address_2": "Suite 100-A",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905035970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.