Provider Demographics
NPI:1891253217
Name:YOON, KUN HO
Entity Type:Individual
Prefix:
First Name:KUN
Middle Name:HO
Last Name:YOON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 WALNUT STREET
Mailing Address - Street 2:THIRD
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107
Mailing Address - Country:US
Mailing Address - Phone:215-503-7118
Mailing Address - Fax:215-503-0682
Practice Address - Street 1:909 WALNUT STREET
Practice Address - Street 2:THIRD
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107
Practice Address - Country:US
Practice Address - Phone:215-503-7118
Practice Address - Fax:215-503-0682
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program