Provider Demographics
NPI:1922317155
Name:DENNIS SON MD INC
Entity Type:Organization
Organization Name:DENNIS SON MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:HYUN
Authorized Official - Last Name:SON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-713-9601
Mailing Address - Street 1:5317 HERITAGE PL
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-4986
Mailing Address - Country:US
Mailing Address - Phone:310-713-9601
Mailing Address - Fax:
Practice Address - Street 1:5317 HERITAGE PL
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-4986
Practice Address - Country:US
Practice Address - Phone:310-713-9601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-06
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA830712085B0100X, 2085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty