Provider Demographics
NPI:1386683639
Name:YOON, PAUL CHUNG-HYUN (DPM)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:CHUNG-HYUN
Last Name:YOON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4554213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
W20099Medicare PIN
5890150001Medicare NSC
V00722Medicare UPIN