Provider Demographics
NPI:1255177440
Name:YOON, JUNGIM (NP)
Entity type:Individual
Prefix:
First Name:JUNGIM
Middle Name:
Last Name:YOON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8141 8TH ST APT 9
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-3065
Mailing Address - Country:US
Mailing Address - Phone:562-237-7592
Mailing Address - Fax:
Practice Address - Street 1:3407 W 6TH ST STE 808
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-2555
Practice Address - Country:US
Practice Address - Phone:213-263-9535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95029941363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily