Provider Demographics
NPI:1740462746
Name:SCOTT K YUN M D INC
Entity type:Organization
Organization Name:SCOTT K YUN M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:K
Authorized Official - Last Name:YUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-907-7600
Mailing Address - Street 1:14350 WHITTIER BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2138
Mailing Address - Country:US
Mailing Address - Phone:562-907-7600
Mailing Address - Fax:562-907-7602
Practice Address - Street 1:14350 WHITTIER BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2138
Practice Address - Country:US
Practice Address - Phone:562-907-7600
Practice Address - Fax:562-907-7602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG65131174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG65131OtherLICENSE
CADJ854AOtherMEDICARE PTAN
CA0620580001Medicare NSC
CAF12135Medicare UPIN