MEDICARE: DR. NAYOUNG EOH D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NX0100X	Occupational Health Chiropractor	DC 28688	CA

General Provider Information

NPI Number	:	1740371301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAYOUNG EOH D.C.

Provider Business Mailing Address
First Line	:	2144 S HACIENDA BLVD
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-4242
Country	:	US
Telephone Number	:	626-968-5882
Fax Number	:	626-968-0020

Provider Business Practice Location Address
First Line	:	2144 S HACIENDA BLVD
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-4242
Country	:	US
Telephone Number	:	626-968-5882
Fax Number	:	626-968-0020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	12/05/2007

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