Provider Demographics
NPI:1194599936
Name:CHRISTOPHER JONG YOO DMD INC
Entity type:Organization
Organization Name:CHRISTOPHER JONG YOO DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, CFO, SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:YOO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:310-283-1691
Mailing Address - Street 1:1661 W 158TH ST APT 204
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-3890
Mailing Address - Country:US
Mailing Address - Phone:310-283-1691
Mailing Address - Fax:
Practice Address - Street 1:9209 COLIMA RD STE 2400
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-1817
Practice Address - Country:US
Practice Address - Phone:310-283-1691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental