Healthcare Provider Details

I. General information

NPI: 1669763223
Provider Name (Legal Business Name): MUNG YING YUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALICE YUNG

II. Dates (important events)

Enumeration Date: 04/29/2011
Last Update Date: 04/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILSHIRE BOULEVARD
LOS ANGELES CA
90073
US

IV. Provider business mailing address

11301 WILSHIRE BOULEVARD
LOS ANGELES CA
90073
US

V. Phone/Fax

Practice location:
  • Phone: 310-268-3152
  • Fax:
Mailing address:
  • Phone: 310-268-3152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: