Provider Demographics
NPI:1245520493
Name:CORONA PEDIATRICS
Entity type:Organization
Organization Name:CORONA PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MIHWA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-255-1796
Mailing Address - Street 1:2815 S MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-2531
Mailing Address - Country:US
Mailing Address - Phone:951-736-5437
Mailing Address - Fax:951-736-5429
Practice Address - Street 1:2815 S MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-2531
Practice Address - Country:US
Practice Address - Phone:951-736-5437
Practice Address - Fax:951-736-5429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-08
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG78754208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty