Provider Demographics
NPI:1619289139
Name:YOUN, JOO-YON JULIA (MD)
Entity Type:Individual
Prefix:DR
First Name:JOO-YON
Middle Name:JULIA
Last Name:YOUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JOO-YON
Other - Middle Name:JULIA
Other - Last Name:SONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4950 SUNSET BLVD.
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027
Mailing Address - Country:US
Mailing Address - Phone:323-783-4516
Mailing Address - Fax:323-783-4771
Practice Address - Street 1:4950 SUNSET BLVD.
Practice Address - Street 2:4TH FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027
Practice Address - Country:US
Practice Address - Phone:323-783-4516
Practice Address - Fax:323-783-4771
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110339207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA110339OtherTHE MEDICAL BOARD OF CALIFORNIA
CAFS1826897OtherDRUG ENFORCEMENT AGENCY