Provider Demographics
NPI:1760253231
Name:NA, DANNY SUNG (RN)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:SUNG
Last Name:NA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 CAJON ST
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-7045
Mailing Address - Country:US
Mailing Address - Phone:951-403-1403
Mailing Address - Fax:
Practice Address - Street 1:1407 CAJON ST
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-7045
Practice Address - Country:US
Practice Address - Phone:951-403-1403
Practice Address - Fax:909-558-9592
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95199324163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse