Organization Active NPI

Van Dyke Yun Dermatology

  • Dermatology Physician
  • Studio City, CA
National Provider Identifier
1326503665
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
VAN DYKE YUN DERMATOLOGY
Practice address
12403 Ventura CT Ste a
Studio City, CA 91604-2470
Phone
(818) 900-6007
Fax
(818) 900-6607
NPI assigned
Jan 31, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Authorized official

Name
Jasmine Yun, MDNPI 1629195656
Title
Owner/Partner
Phone
(818) 595-3582

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

12403 Ventura CT Ste a
Studio City, CA 91604-2470

Mailing address

12403 Ventura CT Ste a
Studio City, CA 91604-2470
Phone (818) 900-6007

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190410001869 CA Part B Supplier - Clinic/Group Practice 3779824271 Receives reassigned benefits from 3 practitioners
Practice locations: Studio City, CA

National Provider Directory

National Provider Directory

Locations

12403 Ventura Ct
Ste A
Studio City, CA 91604
Phone (818) 900-6007

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1326503665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12403 VENTURA CT STE A",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042470",
            "telephone_number": "818-900-6007",
            "fax_number": "818-900-6607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12403 VENTURA CT STE A",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042470",
            "telephone_number": "818-900-6007",
            "fax_number": "818-900-6607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN DYKE YUN DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-02-12",
        "status": "A",
        "authorized_official_last_name": "YUN",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "818-595-3582",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Studio City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.