Healthcare Provider Details

I. General information

NPI: 1194408781
Provider Name (Legal Business Name): JOEL HYUN OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20700 AVALON BLVD STE 343
CARSON CA
90746-3716
US

IV. Provider business mailing address

20700 AVALON BLVD STE 343
CARSON CA
90746-3716
US

V. Phone/Fax

Practice location:
  • Phone: 310-532-2622
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number35577
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: