MEDICARE: DR. JESSICA YOON M.D.

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	207N00000X	Dermatology Physician	MD171107	OR
2	207N00000X	Dermatology Physician	DR.0060211	CO
3	207N00000X	Dermatology Physician	MD2017-0862	NM
4	207N00000X	Dermatology Physician	C156843	CA
5	207N00000X	Dermatology Physician	ME108361	FL

General Provider Information

NPI Number	:	1831352418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA YOON M.D.

Provider Business Mailing Address
First Line	:	1067 S HOVER ST STE E
Second Line	:
City	:	LONGMONT
State	:	CO
Zip	:	80501-7903
Country	:	US
Telephone Number	:	720-464-1011
Fax Number	:

Provider Business Practice Location Address
First Line	:	1067 S HOVER ST STE E
Second Line	:
City	:	LONGMONT
State	:	CO
Zip	:	80501-7903
Country	:	US
Telephone Number	:	720-464-1011
Fax Number	:

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

Provider Enumeration Date	:	07/03/2008
Last Update Date	:	03/17/2026

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