Provider Demographics
NPI:1447423991
Name:WHITTIER UROLOGICAL LAB, LLC
Entity type:Organization
Organization Name:WHITTIER UROLOGICAL LAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:K
Authorized Official - Last Name:YUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-907-7600
Mailing Address - Street 1:8135 PAINTER AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-3102
Mailing Address - Country:US
Mailing Address - Phone:562-907-7600
Mailing Address - Fax:562-907-7602
Practice Address - Street 1:8135 PAINTER AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-3102
Practice Address - Country:US
Practice Address - Phone:562-907-7600
Practice Address - Fax:562-907-7602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG65131291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1265503965OtherDR. LAI INDIV.NPI
CA1518037019OtherDR.POLITO INDIV. NPI
CA1699847046OtherDR.YUN INDIV. NPI