Healthcare Provider Details

I. General information

NPI: 1750826970
Provider Name (Legal Business Name): RICHARD YOON DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2016
Last Update Date: 12/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5630 E SANTA ANA CANYON RD #150
ANAHEIM CA
92807-3122
US

IV. Provider business mailing address

201 E CHAPMAN AVE 31G
PLACENTIA CA
92870-4650
US

V. Phone/Fax

Practice location:
  • Phone: 714-282-7701
  • Fax:
Mailing address:
  • Phone: 562-644-3896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT292368
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: