Provider Demographics
NPI:1932540341
Name:PYUN, YONG UK
Entity Type:Individual
Prefix:
First Name:YONG UK
Middle Name:
Last Name:PYUN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7885 FLAGER CIR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-7435
Mailing Address - Country:US
Mailing Address - Phone:703-409-6975
Mailing Address - Fax:
Practice Address - Street 1:13890 BRADDOCK RD STE 304C
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-2438
Practice Address - Country:US
Practice Address - Phone:703-825-7002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-13
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121001070171100000X
DCAC500145171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0121001070OtherVIRGINIA BOARD OF MEDICINE