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General NPI Number Information
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NPI Number | 1417103946
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Entity Type | Individual
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Provider Name | YOUNG JUN DDS/MD
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Gender | Male
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Dates
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Enumeration Date | 08/15/2008
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Last Update Date | 06/15/2015
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Provider Practice Location Address
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Address Line | 601 E YORBA LINDA BLVD 9
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City | PLACENTIA
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State | CA
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Zip | 92870-3006
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Country | US
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Telephone | 714-985-9690
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Fax | 714-985-1762
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Provider Business Mailing Address
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Address Line | 601 E YORBA LINDA BLVD SUITE 9
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City | PLACENTIA
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State | CA
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Zip | 92870-3006
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Country | US
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Telephone | 714-985-9690
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Fax | 714-985-1762
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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 | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | A109352
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License Number State | CA
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