Provider Demographics
NPI:1750826970
Name:YOON, RICHARD (DPT)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:YOON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E CHAPMAN AVE
Mailing Address - Street 2:31G
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-4650
Mailing Address - Country:US
Mailing Address - Phone:562-644-3896
Mailing Address - Fax:
Practice Address - Street 1:5630 E SANTA ANA CANYON RD
Practice Address - Street 2:#150
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-3122
Practice Address - Country:US
Practice Address - Phone:714-282-7701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-23
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT292368225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist