Healthcare Provider Details

I. General information

NPI: 1477916054
Provider Name (Legal Business Name): RICHARD YOUN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW DEPT OF PLASTIC SURGERY
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

3800 RESERVOIR RD NW DEPT OF PLASTIC SURGERY
WASHINGTON DC
20007-2113
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-1233
  • Fax: 202-444-7422
Mailing address:
  • Phone: 202-444-1233
  • Fax: 202-444-7422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMD210002169
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: