Provider Demographics
NPI:1457119893
Name:SOHN, KYUJIN ALEXANDER
Entity Type:Individual
Prefix:
First Name:KYUJIN
Middle Name:ALEXANDER
Last Name:SOHN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 ALEVERA ST
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-7018
Mailing Address - Country:US
Mailing Address - Phone:480-338-7429
Mailing Address - Fax:
Practice Address - Street 1:83 ALEVERA ST
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-7018
Practice Address - Country:US
Practice Address - Phone:480-338-7429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program