MEDICARE: KYU HO YUN MD

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	207R00000X	Internal Medicine Physician	A33745	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366491383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYU HO YUN MD

Provider Business Mailing Address
First Line	:	12828 HARBOR BL
Second Line	:	#320
City	:	GARDEN GROVE
State	:	CA
Zip	:	92840-2005
Country	:	US
Telephone Number	:	714-636-0133
Fax Number	:	714-636-3833

Provider Business Practice Location Address
First Line	:	12828 HARBOR BL
Second Line	:	#320
City	:	GARDEN GROVE
State	:	CA
Zip	:	92840-2005
Country	:	US
Telephone Number	:	714-636-0133
Fax Number	:	714-636-3833

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	12/15/2010

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