Provider Demographics
NPI:1194920470
Name:YOON, STEVE (MD)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:
Last Name:YOON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 512906
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-0906
Mailing Address - Country:US
Mailing Address - Phone:310-665-7200
Mailing Address - Fax:
Practice Address - Street 1:6801 PARK TER
Practice Address - Street 2:400
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-1543
Practice Address - Country:US
Practice Address - Phone:310-665-7200
Practice Address - Fax:888-972-9261
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA107498208100000X, 2081P2900X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADI433ZMedicare PIN