Provider Demographics
NPI:1730104753
Name:SOHN, SAE H (MD)
Entity Type:Individual
Prefix:DR
First Name:SAE
Middle Name:H
Last Name:SOHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1100 S ELISEO DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2017
Mailing Address - Country:US
Mailing Address - Phone:415-464-8688
Mailing Address - Fax:415-464-8042
Practice Address - Street 1:1100 S ELISEO DR
Practice Address - Street 2:SUITE 107
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2017
Practice Address - Country:US
Practice Address - Phone:415-464-8688
Practice Address - Fax:415-464-8042
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG83090174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist