Healthcare Provider Details

I. General information

NPI: 1598094534
Provider Name (Legal Business Name): HAEJUNG YOON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2009
Last Update Date: 12/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1332 PARK ST SUITE 202
ALAMEDA CA
94501-4545
US

IV. Provider business mailing address

5025 ESCALON CIR
EL SOBRANTE CA
94803-2055
US

V. Phone/Fax

Practice location:
  • Phone: 510-523-3417
  • Fax:
Mailing address:
  • Phone: 917-656-5467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA 109233
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: