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General NPI Number Information
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NPI Number | 1053991646
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Entity Type | Individual
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Provider Name | CATHERINE ROSE YUN
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Gender | Female
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Dates
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Enumeration Date | 04/09/2021
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 1810 GRAND CANAL BLVD STE 2
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City | STOCKTON
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State | CA
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Zip | 95207-8110
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Country | US
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Telephone | 209-952-1612
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Fax | 209-952-1613
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Provider Business Mailing Address
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Address Line | 99 HIGHWAY 37 W
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City | TOMS RIVER
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State | NJ
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Zip | 08755-6423
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Country | US
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Telephone | 732-557-2604
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E6144
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License Number State | CA
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