Provider Demographics
NPI:1609987486
Name:YUN, EUN MI (MD)
Entity Type:Individual
Prefix:
First Name:EUN
Middle Name:MI
Last Name:YUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 S ALVARADO ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-4018
Mailing Address - Country:US
Mailing Address - Phone:213-388-6000
Mailing Address - Fax:213-388-0996
Practice Address - Street 1:819 S ALVARADO ST
Practice Address - Street 2:SUITE 101
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-4018
Practice Address - Country:US
Practice Address - Phone:213-388-6000
Practice Address - Fax:213-388-0996
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA48497207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE89700Medicare UPIN
CAA48497Medicare PIN