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General NPI Number Information
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NPI Number | 1255405429
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Entity Type | Individual
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Provider Name | JEUNG CJOO YOO MD
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 264 N HIGHLAND SPRINGS AVE 2B
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City | BANNING
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State | CA
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Zip | 92220-3082
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Country | US
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Telephone | 951-845-1603
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Fax | 951-845-1773
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Provider Business Mailing Address
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Address Line | 26063 MISSION RD
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City | LOMA LINDA
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State | CA
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Zip | 92354-6506
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Country | US
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Telephone | 909-381-4354
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Fax | 951-845-1773
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | A32076
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License Number State | CA
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