Provider Demographics
NPI:1568482859
Name:POA, HYUNAH L (MD)
Entity Type:Individual
Prefix:DR
First Name:HYUNAH
Middle Name:L
Last Name:POA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:501 DEEP VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-7605
Mailing Address - Country:US
Mailing Address - Phone:310-303-3953
Mailing Address - Fax:310-303-7903
Practice Address - Street 1:501 DEEP VALLEY DR
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-7605
Practice Address - Country:US
Practice Address - Phone:310-303-3953
Practice Address - Fax:310-303-7903
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG076907207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G769070Medicaid
F22233Medicare UPIN
CA00G769070Medicare ID - Type Unspecified