Provider Demographics
NPI:1851828701
Name:ELISABETH SUNGHEE YOUN
Entity type:Organization
Organization Name:ELISABETH SUNGHEE YOUN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:S
Authorized Official - Last Name:YOUN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:213-483-6563
Mailing Address - Street 1:PO BOX 29034
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-0034
Mailing Address - Country:US
Mailing Address - Phone:213-483-6563
Mailing Address - Fax:213-483-6560
Practice Address - Street 1:1711 W TEMPLE ST STE 4675
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-7336
Practice Address - Country:US
Practice Address - Phone:213-483-6563
Practice Address - Fax:213-483-6560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-22
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty