Provider Demographics
NPI:1942435144
Name:YOON, RYAN RAHEE (MD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:RAHEE
Last Name:YOON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:499 H ST
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-4307
Mailing Address - Country:US
Mailing Address - Phone:619-687-7587
Mailing Address - Fax:619-691-7120
Practice Address - Street 1:865 3RD AVE
Practice Address - Street 2:SUITE 133
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-1300
Practice Address - Country:US
Practice Address - Phone:619-498-6200
Practice Address - Fax:619-425-1184
Is Sole Proprietor?:No
Enumeration Date:2009-05-18
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA114600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine