Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 32424 | CA |
NPI | 1194013599 |
---|---|
Provider Name | Dr. Injoon Bernard Yoo |
First Address | Los Angeles, CA 90010 |
Second Address | Los Angeles, CA 90010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2011 |
Last Update Date | 19/07/2011 |