Healthcare Provider Details

I. General information

NPI: 1548188592
Provider Name (Legal Business Name): GOHYUN YU L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3975 JACKSON ST STE 209
RIVERSIDE CA
92503-3949
US

IV. Provider business mailing address

111 POINTE DR
BREA CA
92821-7636
US

V. Phone/Fax

Practice location:
  • Phone: 951-351-2377
  • Fax: 951-351-2378
Mailing address:
  • Phone: 213-700-2025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC20622
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: