Healthcare Provider Details

I. General information

NPI: 1053240382
Provider Name (Legal Business Name): HYEWON SON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 W OLYMPIC BLVD STE 206
LOS ANGELES CA
90006-6511
US

IV. Provider business mailing address

3003 W OLYMPIC BLVD STE 206
LOS ANGELES CA
90006-6511
US

V. Phone/Fax

Practice location:
  • Phone: 213-352-9543
  • Fax:
Mailing address:
  • Phone: 213-352-9543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number20653
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: