MEDICARE: DAVID YOO DMD,INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	302R00000X	Health Maintenance Organization	51676	CA

General Provider Information

NPI Number	:	1326273129
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID YOO DMD,INC

Provider Business Mailing Address
First Line	:	2326 W PICO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-4002
Country	:	US
Telephone Number	:	213-387-4366
Fax Number	:	213-387-3547

Provider Business Practice Location Address
First Line	:	2326 W PICO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-4002
Country	:	US
Telephone Number	:	213-387-4366
Fax Number	:	213-387-3547

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID D YOO
Credential	:	DMD
Telephone Number	:	213-387-4366

Provider Enumeration Date	:	05/22/2009
Last Update Date	:	05/22/2009

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