MEDICARE: SAM YOON 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	208000000X	Pediatrics Physician	A33684	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	:	1538272802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAM YOON MD

Provider Business Mailing Address
First Line	:	4177 REDONDO BEACH BLVD
Second Line	:
City	:	LAWNDALE
State	:	CA
Zip	:	90260-3340
Country	:	US
Telephone Number	:	310-214-1407
Fax Number	:	310-214-1488

Provider Business Practice Location Address
First Line	:	4177 REDONDO BEACH BLVD
Second Line	:
City	:	LAWNDALE
State	:	CA
Zip	:	90260-3340
Country	:	US
Telephone Number	:	310-214-1407
Fax Number	:	310-214-1488

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	07/08/2007

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Directions to “ SAM YOON MD” Practice Location

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