Healthcare Provider Details

I. General information

NPI: 1134024433
Provider Name (Legal Business Name): YM LIFE TREE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2787 E DEL AMO BLVD H5-C
RANCHO DOMINGUEZ CA
90221
US

IV. Provider business mailing address

4128 W COMMONWEALTH AVE STE 104
FULLERTON CA
92833-2565
US

V. Phone/Fax

Practice location:
  • Phone: 714-392-8962
  • Fax:
Mailing address:
  • Phone: 714-392-8962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateNULL

VIII. Authorized Official

Name: HYEONGJIN YOUN
Title or Position: CEO
Credential: L.AC.
Phone: 714-392-8962