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General NPI Number Information
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NPI Number | 1093486953
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Entity Type | Individual
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Provider Name | JAMIE JUNGWON YOON NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 09/21/2021
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Last Update Date | 09/27/2021
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Provider Practice Location Address
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Address Line | 2727 W OLYMPIC BLVD STE 205
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City | LOS ANGELES
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State | CA
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Zip | 90006-2640
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Country | US
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Telephone | 213-529-4251
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Fax |
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Provider Business Mailing Address
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Address Line | 3140 SAN MARINO ST UNIT 403
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City | LOS ANGELES
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State | CA
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Zip | 90006-1475
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Country | US
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Telephone | 714-356-7311
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 95018496
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License Number State | CA
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