Healthcare Provider Details

I. General information

NPI: 1851850903
Provider Name (Legal Business Name): JENNIFER YOON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9481 PITTSBURGH AVE STE 200
RANCHO CUCAMONGA CA
91730-9021
US

IV. Provider business mailing address

9481 PITTSBURGH AVE STE 200
RANCHO CUCAMONGA CA
91730-9021
US

V. Phone/Fax

Practice location:
  • Phone: 909-655-0300
  • Fax: 909-655-1161
Mailing address:
  • Phone: 909-655-0300
  • Fax: 909-655-1161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA177786
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: