Provider Demographics
NPI:1982161113
Name:ST. LUKE MEDICAL ARTS INC
Entity Type:Organization
Organization Name:ST. LUKE MEDICAL ARTS INC
Other - Org Name:DONGJIN SUNG, M.D. INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:M.D. / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONGJIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-868-9146
Mailing Address - Street 1:1740 W GARDENA BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-4764
Mailing Address - Country:US
Mailing Address - Phone:424-551-3110
Mailing Address - Fax:844-272-8062
Practice Address - Street 1:1740 W GARDENA BLVD
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-4764
Practice Address - Country:US
Practice Address - Phone:424-551-3110
Practice Address - Fax:844-272-8062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty