Provider Demographics
NPI:1003860867
Name:YUN, YOUNG SOOK (MD)
Entity Type:Individual
Prefix:
First Name:YOUNG
Middle Name:SOOK
Last Name:YUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:12828 HARBOR BLVD
Mailing Address - Street 2:#320
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-2005
Mailing Address - Country:US
Mailing Address - Phone:714-636-0133
Mailing Address - Fax:714-636-3833
Practice Address - Street 1:12828 HARBOR BLVD
Practice Address - Street 2:#320
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-2005
Practice Address - Country:US
Practice Address - Phone:714-636-0133
Practice Address - Fax:714-636-3833
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2010-12-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA00A3378002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA33780Medicare ID - Type Unspecified