Provider Demographics
NPI:1881997278
Name:ROH, SUN HO (DC)
Entity type:Individual
Prefix:
First Name:SUN
Middle Name:HO
Last Name:ROH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 STOCKER ST STE 104A
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-5145
Mailing Address - Country:US
Mailing Address - Phone:323-299-7606
Mailing Address - Fax:323-299-7636
Practice Address - Street 1:3701 STOCKER ST STE 104A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-5145
Practice Address - Country:US
Practice Address - Phone:323-299-7606
Practice Address - Fax:323-299-7636
Is Sole Proprietor?:No
Enumeration Date:2010-12-07
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-31539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor