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General NPI Number Information
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NPI Number | 1417934316
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Entity Type | Individual
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Provider Name | PAUL BYOUNGJAE YOO O.D
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Gender | Male
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 1150 N HARBOR BLVD SUITE 118
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City | ANAHEIM
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State | CA
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Zip | 92801-2400
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Country | US
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Telephone | 714-758-0185
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Fax | 714-758-0759
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Provider Business Mailing Address
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Address Line | 1150 N. HARBOR BLVD SUITE 118
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City | ANAHEIM
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State | CA
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Zip | 92801-2400
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Country | US
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Telephone | 714-758-0185
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Fax | 714-758-0759
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT-110408LTG
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT11408T
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License Number State | CA
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