Active NPI
Keonseok Yoon, AU.D.
- Audiologist
- Fullerton, CA
National Provider Identifier
1093408262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 3850
- Practice address
- 2240 N Harbor Blvd Ste 200
Fullerton, CA 92835-2635 - Phone
- (714) 447-4100
- NPI assigned
- Jun 1, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 743 | CT | |
| Audiologist | 231H00000X | 3850 | CA | Primary |
Addresses
Primary practice location
2240 N Harbor Blvd Ste 200
Fullerton, CA 92835-2635
Mailing address
5600 River Way Apt J
Buena Park, CA 90621-1724
Phone (860) 786-8343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3850 | CA | MD | Pediatric Occupational Therapist |
| 743 | CT | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698364800000",
"number": "1093408262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5600 RIVER WAY APT J",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906211724",
"telephone_number": "860-786-8343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2240 N HARBOR BLVD STE 200",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928352635",
"telephone_number": "714-447-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOON",
"first_name": "KEONSEOK",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-01",
"last_updated": "2023-10-27",
"certification_date": "2023-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "CT",
"license": "743",
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "CA",
"license": "3850",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.