Doctor Name: | ANDREW GLEN YUN |
NPI Number: | 1083674410 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | A79179 |
Business Practice Address: | 13160 Mindanao Way Suite 300 Marina Del Rey, CA - 902926393 |
Business Phone Number: | 3105740400 |
Business Fax Number: | 3105740401 |
Mailing Address: | 122 Sheldon Street, EL SEGUNDO |
State: | CA |
Postal Code: | 902453915 |
Phone Number: | 3103224278 |
Fax Number: | 3103228251 |
NPI Enumeration Date: | 03/28/2006 |
NPI Last Update Date: | 08/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | A79179 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |