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General NPI Number Information
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NPI Number | 1942642855
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Entity Type | Organization
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Legal Business Name | JUNG JIN LEEYOON INC
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Dates
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Enumeration Date | 07/19/2013
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Last Update Date | 10/08/2019
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Provider Practice Location Address
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Address Line | 10800 PARAMOUNT BLVD #207
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City | DOWNEY
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State | CA
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Zip | 90241-3331
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Country | US
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Telephone | 562-862-6525
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Fax | 562-862-6526
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Provider Business Mailing Address
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Address Line | 10800 PARAMOUNT BLVD #207
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City | DOWNEY
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State | CA
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Zip | 90241-3331
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Country | US
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Telephone | 562-862-6525
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Fax | 562-862-6526
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | JUNG JIN LEEYOON
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Credential |
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Telephone | 562-862-6525
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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 | 50777
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License Number State | CA
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