Provider Demographics
NPI:1619073806
Name:RHEE, IN SOOK ANGELA (MD)
Entity Type:Individual
Prefix:DR
First Name:IN SOOK
Middle Name:ANGELA
Last Name:RHEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:IN SOOK
Other - Middle Name:A
Other - Last Name:RHEE SUH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4220 W 3RD ST
Mailing Address - Street 2:#205
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020
Mailing Address - Country:US
Mailing Address - Phone:213-386-0183
Mailing Address - Fax:213-386-6341
Practice Address - Street 1:4220 W 3RD ST
Practice Address - Street 2:#205
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020
Practice Address - Country:US
Practice Address - Phone:213-386-0183
Practice Address - Fax:213-386-6341
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25957208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A259520Medicaid