Individual provider Active NPI

Dong Joon Yoon, D.C.

  • Chiropractor
  • Garden Grove, CA
National Provider Identifier
1073639381
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
21842 Issued in CA
Practice address
12620 Brookhurst St # 5
Garden Grove, CA 92840-4875
Phone
(714) 539-1717
Fax
(714) 539-5555
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 21842 CA Primary

Addresses

Primary practice location

12620 Brookhurst St # 5
Garden Grove, CA 92840-4875

Mailing address

12620 Brookhurst St # 5
Garden Grove, CA 92840-4875
Phone (714) 539-1717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050822000714 CA Practitioner - Chiropractic 3274561667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1991
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12620 Brookhurst St
Suite 5
Garden Grove, CA 92840-4875
Phone (714) 539-1717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Yoon Chiropractic., Inc. Chiropractor CurrentSince Jan 3, 2003 Accepting new patients

Locations

12620 Brookhurst St
#5
Garden Grove, CA 92840
Phone (714) 539-1717

8281 Garden Grove Blvd
Ste C
Garden Grove, CA 92844
Phone (714) 539-1717

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1073639381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12620 BROOKHURST ST # 5",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404875",
            "telephone_number": "714-539-1717",
            "fax_number": "714-539-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12620 BROOKHURST ST # 5",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404875",
            "telephone_number": "714-539-1717",
            "fax_number": "714-539-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "DONG JOON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "21842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.