Provider Demographics
NPI:1902125669
Name:YUN, YONG C (DC)
Entity Type:Individual
Prefix:
First Name:YONG
Middle Name:C
Last Name:YUN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 ORANGETHORPE AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-3457
Mailing Address - Country:US
Mailing Address - Phone:714-670-0007
Mailing Address - Fax:714-670-0005
Practice Address - Street 1:7700 ORANGETHORPE AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-3457
Practice Address - Country:US
Practice Address - Phone:714-670-0007
Practice Address - Fax:714-670-0005
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-20
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28923111N00000X
CAAC9781171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC28923OtherCHIROPRACTOR
CAAC9781OtherACUPUNCTURIST