Provider Demographics
NPI:1932660693
Name:YOUN, CINDY SE YEON (DO)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:SE YEON
Last Name:YOUN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4329 W 190TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-5510
Mailing Address - Country:US
Mailing Address - Phone:310-365-1116
Mailing Address - Fax:
Practice Address - Street 1:1441 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4418
Practice Address - Country:US
Practice Address - Phone:559-494-4030
Practice Address - Fax:559-334-3145
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY322612207L00000X
64251390200000X
CA20A21678207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program