Healthcare Provider Details

I. General information

NPI: 1730238692
Provider Name (Legal Business Name): STEVE S. YOON, DPM A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 08/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12555 GARDEN GROVE BLVD STE 303
GARDEN GROVE CA
92843-1903
US

IV. Provider business mailing address

1315 N TUSTIN ST # I-383
ORANGE CA
92867-3905
US

V. Phone/Fax

Practice location:
  • Phone: 714-537-4100
  • Fax: 714-537-4126
Mailing address:
  • Phone: 714-547-3346
  • Fax: 714-547-3252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberE4436
License Number StateCA

VIII. Authorized Official

Name: STEVE S YOON
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 714-547-3346