Provider Demographics
NPI:1295915585
Name:RHEEM, DAE SOON (MD)
Entity type:Individual
Prefix:
First Name:DAE
Middle Name:SOON
Last Name:RHEEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 S VIRGIL AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-1406
Mailing Address - Country:US
Mailing Address - Phone:213-381-3630
Mailing Address - Fax:
Practice Address - Street 1:505 S VIRGIL AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1406
Practice Address - Country:US
Practice Address - Phone:213-381-3630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92866207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine