Provider Demographics
NPI:1114007747
Name:YOON, LUKE WHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:WHAN
Last Name:YOON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S HOBART BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-3635
Mailing Address - Country:US
Mailing Address - Phone:213-387-6564
Mailing Address - Fax:213-387-3495
Practice Address - Street 1:300 S HOBART BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-3635
Practice Address - Country:US
Practice Address - Phone:213-387-6564
Practice Address - Fax:213-387-3495
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG083776174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G837760Medicaid
CA00G837760Medicaid
CAG54754Medicare UPIN