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General NPI Number Information
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NPI Number | 1730178369
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Entity Type | Individual
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Provider Name | ELISABETH SUNGHEE YOUN D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 1711 W TEMPLE ST STE 6657
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City | LOS ANGELES
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State | CA
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Zip | 90026-7338
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Country | US
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Telephone | 213-483-6563
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Fax | 213-483-6560
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Provider Business Mailing Address
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Address Line | PO BOX 29034
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City | LOS ANGELES
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State | CA
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Zip | 90029-0034
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Country | US
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Telephone | 213-483-6563
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Fax | 213-483-6560
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | E4458
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License Number State | CA
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