Provider Demographics
NPI:1497087571
Name:PRIMARY CARE MEDICINE
Entity Type:Organization
Organization Name:PRIMARY CARE MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNG
Authorized Official - Middle Name:Y
Authorized Official - Last Name:RHIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-341-4422
Mailing Address - Street 1:11175 E MISSISSIPPI AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3137
Mailing Address - Country:US
Mailing Address - Phone:303-341-4422
Mailing Address - Fax:720-389-5849
Practice Address - Street 1:11175 E MISSISSIPPI AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3137
Practice Address - Country:US
Practice Address - Phone:303-341-4422
Practice Address - Fax:720-389-5849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO27322174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty