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Organization
REGENTS OF THE UNIVERSITY OF UCLA MAXILLOFACIAL PROSTHODONTICS
Active
Organization
REGENTS OF THE UNIVERSITY OF UCLA MAXILLOFACIAL PROSTHODONTICS
Active
Other names
UCLA Maxillofacial Prosthetics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC C SUNG DDS (DIRECTOR)
(310) 206-6407
Entity
Organization
Contact information
Practice address
10833 LE CONTE AVE RM AO-156A CHS, BOX 951668, LOS ANGELES, CA 90095-3075
(310) 825-6510
(310) 206-4201
Mailing address
10833 LE CONTE AVE RM AO-156A, BOX 951668, LOS ANGELES, CA 90095-3075
(310) 825-6510
(310) 206-4201
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
38370
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G91297
—
CA
Enumeration date
01/30/2007
Last updated
12/12/2014
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