Individual
EDWARD JAESUNG AHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7750 DAGGET ST STE 108, SAN DIEGO, CA 92111-2235
(858) 571-1004
(858) 571-1006
Mailing address
7750 DAGGET ST STE 108, SAN DIEGO, CA 92111-2235
(858) 571-1004
(858) 571-1006
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A38304
CA
208D00000X
General Practice Physician
Primary
A38304
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00Q383040
—
CA
Enumeration date
10/13/2006
Last updated
08/02/2022
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