Basic Information
| Provider Information | |||||||||
| NPI: | 1619041316 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WHANG | ||||||||
| FirstName: | SUK | ||||||||
| MiddleName: | CHARLES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | WHANG | ||||||||
| OtherFirstName: | CHARLES | ||||||||
| OtherMiddleName: | SUK | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | DAVID GRANT MEDICAL CENTER | ||||||||
| Address2: | 101 BODIN CIRCLE | ||||||||
| City: | TRAVIS AFB | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945351800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7074233040 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | DAVID GRANT MEDICAL CENTER | ||||||||
| Address2: | 101 BODIN CIRCLE | ||||||||
| City: | TRAVIS AFB | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945351800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7074233040 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2006 | ||||||||
| LastUpdateDate: | 05/17/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | A87386 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.