Provider Demographics
NPI:1508895871
Name:SON-HA AND DIEM-CHI A MEDICAL CORP
Entity Type:Organization
Organization Name:SON-HA AND DIEM-CHI A MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HA
Authorized Official - Middle Name:SON
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-218-8778
Mailing Address - Street 1:1951 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-5321
Mailing Address - Country:US
Mailing Address - Phone:562-218-8778
Mailing Address - Fax:562-218-1916
Practice Address - Street 1:1951 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-5321
Practice Address - Country:US
Practice Address - Phone:562-218-8778
Practice Address - Fax:562-218-1916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG67118207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G671180Medicaid
CA00G671180Medicaid