Provider Demographics
NPI:1760510747
Name:YUN, KATHERINE JUNGMI
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JUNGMI
Last Name:YUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 W SAN CARLOS ST STE G
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-5245
Mailing Address - Country:US
Mailing Address - Phone:408-316-3553
Mailing Address - Fax:
Practice Address - Street 1:1661 W SAN CARLOS ST STE G
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-5245
Practice Address - Country:US
Practice Address - Phone:408-316-3553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0066520171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist