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NPI Code Detail

MEDICARE: CHARLES WOOCHANG YOON

MEDICARE: CHARLES WOOCHANG YOON
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
1183500000XPharmacist73535CA

General Provider Information

NPI Number : 1083063630
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES WOOCHANG YOON
Provider Business Mailing Address
First Line : 8900 SEPULVEDA WESTWAY
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-3619
Country : US
Telephone Number : 310-258-0256
Fax Number :
Provider Business Practice Location Address
First Line : 8900 SEPULVEDA WESTWAY
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-3619
Country : US
Telephone Number : 310-258-0256
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2016
Last Update Date : 06/05/2016

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