Individual provider Active NPI

Paul S Yoon, M.D.

  • Family Medicine Physician
  • Lakewood, CA
National Provider Identifier
1174610125
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A30466 Issued in CA
Practice address
3650 South St Ste 207
Lakewood, CA 90712-1524
Phone
(562) 220-2727
Fax
(562) 220-2345
NPI assigned
Oct 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A30466 CA Primary

Addresses

Primary practice location

3650 South St Ste 207
Lakewood, CA 90712-1524

Mailing address

3650 South St Ste 207
Lakewood, CA 90712-1524
Phone (562) 220-2727

Other identifiers 1

IdentifierTypeStateIssuer
00A3046600MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081202000317 CA Practitioner - Family Practice 8527129188 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pioneer Medical Group Inc. CurrentSince Apr 25, 2017 Accepting new patients

Locations

10251 Artesia Blvd
Bellflower, CA 90706
Phone (562) 229-9452

17777 Center Court Dr N
Ste 400
Cerritos, CA 90703
Phone (562) 229-9452

2220 Clark Ave
Long Beach, CA 90815
Phone (562) 597-4181

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": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174610125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST STE 207",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121524",
            "telephone_number": "562-220-2727",
            "fax_number": "562-220-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST STE 207",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121524",
            "telephone_number": "562-220-2727",
            "fax_number": "562-220-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "PAUL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A30466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A3046600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

Verify at the official NPI Registry.