Provider Demographics
NPI:1265512032
Name:PAUL C. YOON, DPM, INC.
Entity Type:Organization
Organization Name:PAUL C. YOON, DPM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:CHUNG-HYUN
Authorized Official - Last Name:YOON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:714-535-3668
Mailing Address - Street 1:1781 W ROMNEYA DR
Mailing Address - Street 2:SUITE I
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1818
Mailing Address - Country:US
Mailing Address - Phone:714-535-3668
Mailing Address - Fax:714-526-6003
Practice Address - Street 1:1781 W ROMNEYA DR
Practice Address - Street 2:SUITE I
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1818
Practice Address - Country:US
Practice Address - Phone:714-535-3668
Practice Address - Fax:714-526-6003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
213E00000X
CAE4554213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
V00722Medicare UPIN
W20099Medicare PIN
5890150001Medicare NSC