Provider Demographics
NPI:1457414989
Name:YUN, DENNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:YUN
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 1:5561 VIA PORTORA UNIT B
Mailing Address - Street 2:
Mailing Address - City:LAGUNA WOODS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-6958
Mailing Address - Country:US
Mailing Address - Phone:855-985-7246
Mailing Address - Fax:855-985-7246
Practice Address - Street 1:13160 MINDANAO WAY STE 300
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-6393
Practice Address - Country:US
Practice Address - Phone:855-985-7246
Practice Address - Fax:855-985-7246
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93764207LP2900X, 208VP0014X, 207LP2900X
VA0101241873207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGZ924AMedicare PIN
VA014462F81Medicare PIN
DC022186F89Medicare PIN