Provider Demographics
NPI:1043238769
Name:MOSES HYUN, M.D INC.
Entity Type:Organization
Organization Name:MOSES HYUN, M.D INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, M.D.
Authorized Official - Prefix:
Authorized Official - First Name:MOSES
Authorized Official - Middle Name:
Authorized Official - Last Name:HYUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-735-1300
Mailing Address - Street 1:966 S WESTERN AVE
Mailing Address - Street 2:STE 204
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-1013
Mailing Address - Country:US
Mailing Address - Phone:323-735-1300
Mailing Address - Fax:323-735-6734
Practice Address - Street 1:966 S WESTERN AVE
Practice Address - Street 2:STE 204
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-1013
Practice Address - Country:US
Practice Address - Phone:323-735-1300
Practice Address - Fax:323-735-6734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2007-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40302207R00000X, 207RC0000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A403020Medicaid
CA00A403020Medicaid
CAA40302Medicare PIN