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NPI Code Detail

MEDICARE: DR. HYUN JIN YI PA-C

MEDICARE: DR. HYUN JIN YI PA-C
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
1363AM0700XMedical Physician Assistant0110010807VA
2363AM0700XMedical Physician AssistantPA13494TX

General Provider Information

NPI Number : 1578955712
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HYUN JIN YI PA-C
Provider Business Mailing Address
First Line : 9300 DEWITT LOOP
Second Line :
City : FORT BELVOIR
State : VA
Zip : 22060-5285
Country : US
Telephone Number : 703-498-0909
Fax Number :
Provider Business Practice Location Address
First Line : 9300 DEWITT LOOP
Second Line :
City : FORT BELVOIR
State : VA
Zip : 22060-5285
Country : US
Telephone Number : 703-498-0909
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2015
Last Update Date : 01/07/2026

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