Provider Demographics
NPI:1598345944
Name:JUNG, YE EUN (MD)
Entity type:Individual
Prefix:DR
First Name:YE EUN
Middle Name:
Last Name:JUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:JUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:12700 E 19TH AVE
Mailing Address - Street 2:RC2, 9TH FLOOR BOX C272
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2560
Mailing Address - Country:US
Mailing Address - Phone:303-724-6043
Mailing Address - Fax:303-724-6042
Practice Address - Street 1:12700 E 19TH AVE
Practice Address - Street 2:RC2, 9TH FLOOR BOX C272
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2560
Practice Address - Country:US
Practice Address - Phone:303-724-6043
Practice Address - Fax:303-724-6042
Is Sole Proprietor?:No
Enumeration Date:2021-04-10
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPG204854390200000X
COTL.0010054390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program