Healthcare Provider Details

I. General information

NPI: 1174567192
Provider Name (Legal Business Name): YOUN S. TOH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 04/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24258 OWL CT
CORONA CA
92883-9193
US

IV. Provider business mailing address

24258 OWL CT
CORONA CA
92883-9193
US

V. Phone/Fax

Practice location:
  • Phone: 951-603-3496
  • Fax:
Mailing address:
  • Phone: 951-603-3496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA30670
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: