MEDICARE: DR. YEONG K AHN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	A45633	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073504031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YEONG K AHN M.D.

Provider Business Mailing Address
First Line	:	1300 N VERMONT AVE
Second Line	:	# 600
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-6098
Country	:	US
Telephone Number	:	213-457-4350
Fax Number	:	213-913-4351

Provider Business Practice Location Address
First Line	:	1300 N VERMONT AVE
Second Line	:	100
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-6005
Country	:	US
Telephone Number	:	323-457-4350
Fax Number	:	323-913-4351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	12/11/2020

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