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General NPI Number Information
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NPI Number | 1134165012
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Entity Type | Organization
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Legal Business Name | THOMAS W. YOO, M.D., INC., A MEDICAL CORP
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 11/11/2021
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Provider Practice Location Address
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Address Line | 555 E HARDY ST
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City | INGLEWOOD
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State | CA
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Zip | 90301-4011
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Country | US
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Telephone | 626-344-7797
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Fax | 626-737-0464
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Provider Business Mailing Address
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Address Line | 1107 FAIR OAKS AVE # 854
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-3311
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Country | US
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Telephone | 626-344-7797
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Fax | 626-737-0464
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Authorized Official
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Title or Position | PRESIDENT / DIRECTOR
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Name | DR. THOMAS WONSUK YOO
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Credential | M.D.
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Telephone | 626-344-7797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | A73559
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License Number State | CA
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