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NPI Code Detail

MEDICARE: DR. JAE WHAN YOON M.D

MEDICARE:  DR. JAE WHAN 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
12085R0202XDiagnostic Radiology PhysicianA36791CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952373508
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAE WHAN YOON M.D
Provider Business Mailing Address
First Line : BOX 5010
Second Line :
City : GLENDORA
State : CA
Zip : 91740-0735
Country : US
Telephone Number : 626-915-5181
Fax Number : 626-331-2313
Provider Business Practice Location Address
First Line : 414 E SAN BERNARDINO RD
Second Line :
City : COVINA
State : CA
Zip : 91723-1704
Country : US
Telephone Number : 626-915-5181
Fax Number : 626-331-2313
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2006
Last Update Date : 10/23/2008

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Directions to “ DR. JAE WHAN YOON M.D” Practice Location

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