Provider Demographics
NPI:1437781119
Name:SUNG, TAEIL D
Entity type:Individual
Prefix:
First Name:TAEIL
Middle Name:D
Last Name:SUNG
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 1:815 HYDE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5996
Mailing Address - Country:US
Mailing Address - Phone:650-240-4453
Mailing Address - Fax:415-292-7140
Practice Address - Street 1:815 HYDE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5996
Practice Address - Country:US
Practice Address - Phone:650-240-4453
Practice Address - Fax:415-292-7140
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker