Provider Demographics
NPI:1518426766
Name:SUNG, CALVIN T (MD)
Entity Type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:T
Last Name:SUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:616 N GARFIELD AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1153
Mailing Address - Country:US
Mailing Address - Phone:626-635-1688
Mailing Address - Fax:712-218-3602
Practice Address - Street 1:616 N GARFIELD AVE STE 203
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1153
Practice Address - Country:US
Practice Address - Phone:626-635-1688
Practice Address - Fax:712-218-3602
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA176236207N00000X, 208D00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice