Healthcare Provider Details

I. General information

NPI: 1629585948
Provider Name (Legal Business Name): HYEONGJIN YOUN L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2018
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
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 Number16993
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: