Provider Demographics
NPI:1790857431
Name:Y.Y. WELLNESS CENTER
Entity Type:Organization
Organization Name:Y.Y. WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WOO
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC,PHD
Authorized Official - Phone:949-718-0012
Mailing Address - Street 1:220 NEWPORT CENTER DR
Mailing Address - Street 2:STE 20
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7506
Mailing Address - Country:US
Mailing Address - Phone:949-718-0012
Mailing Address - Fax:949-718-0012
Practice Address - Street 1:220 NEWPORT CENTER DR
Practice Address - Street 2:STE 20
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7506
Practice Address - Country:US
Practice Address - Phone:949-718-0012
Practice Address - Fax:949-718-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8452302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADOC ID 1051079OtherLAC., PHD