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General NPI Number Information
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NPI Number | 1477756914
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Entity Type | Organization
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Legal Business Name | JONATHAN C YEUNG DDS, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 05/18/2012
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Provider Practice Location Address
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Address Line | 7217 DE SOTO AVE
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City | CANOGA PARK
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State | CA
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Zip | 91303-1702
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Country | US
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Telephone | 818-704-0749
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Fax |
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Provider Business Mailing Address
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Address Line | 2324 EL CAPITAN AVE
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City | ARCADIA
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State | CA
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Zip | 91006-5111
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Country | US
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Telephone | 818-704-0749
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JONATHAN C YEUNG
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Credential | DDS
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Telephone | 818-704-0749
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 47588
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License Number State | CA
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