MEDICARE: MRS. EUN JOO YOON 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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	A54010	CA
2	207R00000X	Internal Medicine Physician	A54010	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
2	11007046	OTHER	CA	CAQH
3	A54010	OTHER	CA	LICENSE

General Provider Information

NPI Number	:	1821091661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EUN JOO YOON M.D.

Provider Business Mailing Address
First Line	:	2560 W OLYMPIC BLVD STE 101B
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2998
Country	:	US
Telephone Number	:	213-480-1000
Fax Number	:	213-386-0211

Provider Business Practice Location Address
First Line	:	2560 W OLYMPIC BLVD STE 101B
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2998
Country	:	US
Telephone Number	:	213-480-1000
Fax Number	:	213-386-0211

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	03/07/2023

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