Organization
LIVINGWATER'S MEDICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN YUJUNG YUN D.O. (PRESIDENT)
(951) 694-8549
Entity
Organization
Contact information
Practice address
24910 LAS BRISAS RD, SUITE 111, MURRIETA, CA 92562-4010
(951) 694-8549
(951) 220-8307
Mailing address
24910 LAS BRISAS RD, SUITE 111, MURRIETA, CA 92562-4010
(951) 694-8549
(951) 220-8307
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
20A8759
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX87590
—
CA
Enumeration date
07/10/2006
Last updated
11/30/2010
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