Provider Demographics
NPI:1598351314
Name:YONSEI MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:YONSEI MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RHEEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-381-3630
Mailing Address - Street 1:505 S VIRGIL AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-1407
Mailing Address - Country:US
Mailing Address - Phone:213-381-3630
Mailing Address - Fax:213-674-7414
Practice Address - Street 1:505 S VIRGIL AVE STE 106
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1407
Practice Address - Country:US
Practice Address - Phone:213-381-3630
Practice Address - Fax:213-674-7414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty