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NPI Code Detail

MEDICARE: DR. YONG JUN DOM

MEDICARE:  DR. YONG  JUN  DOM
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
1171100000XAcupuncturistAC17118CA

General Provider Information

NPI Number : 1790133635
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YONG JUN DOM
Provider Business Mailing Address
First Line : 6939 SUNRISE BLVD STE 226
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95610-3153
Country : US
Telephone Number : 916-677-9818
Fax Number : 916-251-7314
Provider Business Practice Location Address
First Line : 6939 SUNRISE BLVD STE 226
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95610-3153
Country : US
Telephone Number : 916-677-9818
Fax Number : 916-251-7314
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2016
Last Update Date : 10/16/2019

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Directions to “ DR. YONG JUN DOM” Practice Location

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