Provider Demographics
NPI:1902863368
Name:SUN YOUNG INC
Entity Type:Organization
Organization Name:SUN YOUNG INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIHO
Authorized Official - Middle Name:
Authorized Official - Last Name:YI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-961-9874
Mailing Address - Street 1:6320 NORTH CENTER DRIVE
Mailing Address - Street 2:BUILDING 15, SUITE 202
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4009
Mailing Address - Country:US
Mailing Address - Phone:757-961-9874
Mailing Address - Fax:757-962-6565
Practice Address - Street 1:6320 N CENTER DR
Practice Address - Street 2:BUILDING 15, SUITE 202
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4009
Practice Address - Country:US
Practice Address - Phone:757-961-9874
Practice Address - Fax:757-962-6565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04240251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010051517Medicaid
VA010095344Medicaid
VA010059739Medicaid
VA116761OtherANTHEM
VA010059739Medicaid
VA=========OtherTRICARE
VA=========OtherSECURE HORIZONE
VA010095344Medicaid
VA=========OtherHOMELINK
VA010051517Medicaid