NPIMap

Organization Active NPI

Sung M.D., a Professional Corporation

  • Dermatology Physician
  • Monterey Park, CA
National Provider Identifier
1972244176
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SUNG M.D., A PROFESSIONAL CORPORATION
Practice address
616 N Garfield Ave Ste 203
Monterey Park, CA 91754-1153
Phone
(626) 635-1688
Fax
(712) 218-3602
NPI assigned
Apr 5, 2022
Last updated
Jul 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Authorized official

Name
Dr. Calvin Sung, MDNPI 1518426766
Title
President/Ceo
Phone
(909) 348-2354

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

616 N Garfield Ave Ste 203
Monterey Park, CA 91754-1153

Mailing address

616 N Garfield Ave Ste 203
Monterey Park, CA 91754-1153
Phone (626) 635-1688

Other practice location 1

515 E Commonwealth Ave
Fullerton, CA 92832-2020
Phone (909) 348-2354

Other practice location 2

180 Newport Center Dr Ste 225
Newport Beach, CA 92660-0904
Phone (714) 712-0438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220722001563 CA Part B Supplier - Clinic/Group Practice 7214318138 Receives reassigned benefits from 10 practitioners
Practice locations: Anaheim, CA; Arcadia, CA; Los Angeles, CA; Monterey Park, CA; Newport Beach, CA; West Covina, CA

National Provider Directory

National Provider Directory

Locations

612 W Duarte Rd
Ste 501
Arcadia, CA 91007
Phone (626) 821-1112

709 N Hill St
Ste 15
Los Angeles, CA 90012
Phone (213) 373-8882

180 Newport Center Dr
Ste 225
Newport Beach, CA 92660
Phone (714) 712-0438

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1972244176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 N GARFIELD AVE STE 203",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541153",
            "telephone_number": "626-635-1688",
            "fax_number": "712-218-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 N GARFIELD AVE STE 203",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541153",
            "telephone_number": "626-635-1688",
            "fax_number": "712-218-3602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 E Commonwealth Ave",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928322020",
            "country_code": "US",
            "telephone_number": "909-348-2354",
            "fax_number": "712-218-3602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "180 Newport Center Dr Ste 225",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926600904",
            "country_code": "US",
            "telephone_number": "714-712-0438",
            "fax_number": "712-218-3602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUNG M.D., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-05",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "SUNG",
        "authorized_official_first_name": "CALVIN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "909-348-2354",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.