MEDICARE: HYUN SOO YUN DDS 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	122300000X	Dentist	CA-50551	CA

General Provider Information

NPI Number	:	1649491077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HYUN SOO YUN DDS INC

Provider Business Mailing Address
First Line	:	14135 FRANCISQUITO AVE
Second Line	:	#107
City	:	BALDWIN PARK
State	:	CA
Zip	:	91706-6107
Country	:	US
Telephone Number	:	626-814-0259
Fax Number	:	626-814-2129

Provider Business Practice Location Address
First Line	:	14135 FRANCISQUITO AVE
Second Line	:	#107
City	:	BALDWIN PARK
State	:	CA
Zip	:	91706-6107
Country	:	US
Telephone Number	:	626-814-0259
Fax Number	:	626-814-2129

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	11/19/2021

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