Provider Demographics
NPI:1942551718
Name:SJ BYEON MEDICAL CORP
Entity Type:Organization
Organization Name:SJ BYEON MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANGJUN
Authorized Official - Middle Name:
Authorized Official - Last Name:BYEON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-912-2911
Mailing Address - Street 1:19115 COLIMA RD UNIT 102
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-3074
Mailing Address - Country:US
Mailing Address - Phone:626-912-2911
Mailing Address - Fax:626-810-5232
Practice Address - Street 1:19115 COLIMA RD UNIT 102
Practice Address - Street 2:
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-3074
Practice Address - Country:US
Practice Address - Phone:626-912-2911
Practice Address - Fax:626-810-5232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA103605207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty