MEDICARE: EMILY JEEYON JEON NP

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	363L00000X	Nurse Practitioner	95030951	CA

General Provider Information

NPI Number	:	1497591572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY JEEYON JEON NP

Provider Business Mailing Address
First Line	:	3828 SCHAUFELE AVE STE 250
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-0016
Country	:	US
Telephone Number	:	657-241-9051
Fax Number	:	714-665-4664

Provider Business Practice Location Address
First Line	:	3828 SCHAUFELE AVE STE 250
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-0016
Country	:	US
Telephone Number	:	657-241-9051
Fax Number	:	714-665-4664

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

Provider Enumeration Date	:	07/08/2024
Last Update Date	:	03/02/2026

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