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General NPI Number Information
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NPI Number | 1801112461
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Entity Type | Individual
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Provider Name | ERICA JEEWON YOO O.D.
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Gender | Female
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Dates
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Enumeration Date | 04/07/2010
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Last Update Date | 07/15/2011
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Provider Practice Location Address
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Address Line | 3537 TORRANCE BLVD SUITE 18
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City | TORRANCE
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State | CA
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Zip | 90503-4818
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Country | US
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Telephone | 562-607-7890
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Fax |
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Provider Business Mailing Address
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Address Line | 2160 CENTURY PARK E #408
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City | LOS ANGELES
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State | CA
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Zip | 90067-2244
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Country | US
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Telephone | 562-607-7890
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Fax |
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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 | 704
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License Number State | HI
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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 | 14118TLG
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License Number State | CA
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