Individual provider Active NPI

Patricia Yun, M.D.

  • Specialist
  • Long Beach, CA
National Provider Identifier
1962468777
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
WA79257A Issued in CA
Practice address
Laser Skin Care Center
3918 Long Beach Boulevard Suite 200
Long Beach, CA 90807-2615
Phone
(562) 989-7829
Fax
(562) 989-7829
NPI assigned
Apr 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X WA79257A CA Primary

Addresses

Primary practice location

Laser Skin Care Center
3918 Long Beach Boulevard Suite 200
Long Beach, CA 90807-2615

Mailing address

Laser Skin Care Center
3918 Long Beach Boulevard Suite 200
Long Beach, CA 90807-2615
Phone (562) 989-7829

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pyun196672@oc.providencedirect.org

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
I20081219000352 CA Practitioner - Dermatology 0345302600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Harvard Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

520 N Prospect Ave
Suite 307
Redondo Beach, CA 90277-3043
Phone (310) 376-8816

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions410
Removal or shaving of skin growth1-10
Skin biopsy104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79257CAMDMental Health Counselor
WA79257ACAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute CurrentSince Jan 1, 2009 Accepting new patients
Providence Medical Institute CurrentSince Jan 1, 2009 Accepting new patients
Providence Medical Institute Current Accepting new patients
Providence Health System Southern California Past Accepting new patients
Little Company of Mary Affiliated Services Inc Past Accepting new patients

Locations

21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627

1010 N Sepulveda Blvd
Manhattan Beach, CA 90266
Phone (310) 322-9700

520 N Prospect Ave
Ste 307
Redondo Beach, CA 90277
Phone (310) 374-3500

3524 Torrance Blvd
Ste 100
Torrance, CA 90503
Phone (310) 316-2055

21311 Madrona Ave
Ste 100B
Torrance, CA 90503
Phone (310) 540-1334

21311 Madrona Ave
Ste 100D
Torrance, CA 90503
Phone (310) 792-4058

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1962468777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LASER SKIN CARE CENTER",
            "address_2": "3918 LONG BEACH BOULEVARD SUITE 200",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072615",
            "telephone_number": "562-989-7829",
            "fax_number": "562-989-7829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LASER SKIN CARE CENTER",
            "address_2": "3918 LONG BEACH BOULEVARD SUITE 200",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072615",
            "telephone_number": "562-989-7829",
            "fax_number": "562-989-7829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUN",
        "first_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "WA79257A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pyun196672@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "21311 Madrona Ave Ste 100B",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905035970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.