MEDICARE: YOUNG C YOO

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	171100000X	Acupuncturist	U02404	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	U02404	OTHER	MD	ACUPUNCTURE

General Provider Information

NPI Number	:	1912420191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOUNG C YOO

Provider Business Mailing Address
First Line	:	3448 ELLICOTT CENTER DR STE 103
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-4668
Country	:	US
Telephone Number	:	301-661-4932
Fax Number	:

Provider Business Practice Location Address
First Line	:	3448 ELLICOTT CENTER DR STE 103
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-4668
Country	:	US
Telephone Number	:	301-661-4932
Fax Number	:

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

Provider Enumeration Date	:	07/19/2017
Last Update Date	:	07/21/2022

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Directions to “ YOUNG C YOO ” Practice Location

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