MEDICARE: CHUNKIL YI

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	122300000X	Dentist	25483	TX

General Provider Information

NPI Number	:	1982924171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHUNKIL YI

Provider Business Mailing Address
First Line	:	9584 DYER ST STE B
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79924-4748
Country	:	US
Telephone Number	:	915-751-1007
Fax Number	:

Provider Business Practice Location Address
First Line	:	9584 DYER ST STE B
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79924-4748
Country	:	US
Telephone Number	:	915-751-1007
Fax Number	:

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

Provider Enumeration Date	:	06/10/2010
Last Update Date	:	11/07/2012

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Directions to “ CHUNKIL YI ” Practice Location

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