Healthcare Provider Details

I. General information

NPI: 1861616781
Provider Name (Legal Business Name): LUKE W. YOON, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 03/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S HOBART BLVD STE 300
LOS ANGELES CA
90020-3693
US

IV. Provider business mailing address

300 S HOBART BLVD STE 300
LOS ANGELES CA
90020-3693
US

V. Phone/Fax

Practice location:
  • Phone: 213-387-6564
  • Fax: 213-387-3495
Mailing address:
  • Phone: 213-387-6564
  • Fax: 213-387-3495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG83776
License Number StateCA

VIII. Authorized Official

Name: LUKE W YOON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 213-387-6564