Provider Demographics
NPI:1871545012
Name:BYUN, TIMOTHY EUIWON (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:EUIWON
Last Name:BYUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 W LA VETA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3928
Mailing Address - Country:US
Mailing Address - Phone:714-835-1800
Mailing Address - Fax:714-835-1811
Practice Address - Street 1:805 W LA VETA AVE STE 101
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3928
Practice Address - Country:US
Practice Address - Phone:714-835-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70195207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
W969OtherGROUP MCARE
CA00A701950734Medicaid
WA70195AMedicare ID - Type UnspecifiedPPIN
CA00A701950734Medicaid