Provider Demographics
NPI:1871695346
Name:MIN, YOON SUNG (MD)
Entity type:Individual
Prefix:DR
First Name:YOON
Middle Name:SUNG
Last Name:MIN
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 1:21060 CENTRE POINTE PKWY
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-2976
Mailing Address - Country:US
Mailing Address - Phone:661-254-1202
Mailing Address - Fax:661-964-0495
Practice Address - Street 1:21060 CENTRE POINTE PKWY
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-2976
Practice Address - Country:US
Practice Address - Phone:661-254-1202
Practice Address - Fax:661-964-0495
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64832207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI01277Medicare UPIN
CAA64632Medicare ID - Type Unspecified