Healthcare Provider Details

I. General information

NPI: 1912249913
Provider Name (Legal Business Name): JANE YOON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAE WON YOON

II. Dates (important events)

Enumeration Date: 03/18/2013
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18035 BROOKHURST STREET, STE 2100
FOUNTAIN VALLEY CA
92708
US

IV. Provider business mailing address

3091 SAGE VIEW CT
FULLERTON CA
92833-5511
US

V. Phone/Fax

Practice location:
  • Phone: 657-241-9090
  • Fax: 714-665-4603
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number290787
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA174872
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: