Healthcare Provider Details

I. General information

NPI: 1265963714
Provider Name (Legal Business Name): YEA EUN ACUPUNCTURE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 03/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

693 E REMINGTON DR STE A
SUNNYVALE CA
94087-1977
US

IV. Provider business mailing address

693 E REMINGTON DR STE A
SUNNYVALE CA
94087-1977
US

V. Phone/Fax

Practice location:
  • Phone: 408-482-9234
  • Fax:
Mailing address:
  • Phone: 408-482-9234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC17256
License Number StateCA

VIII. Authorized Official

Name: DR. SANG EON KIM
Title or Position: CEO
Credential: D.C.,LAC
Phone: 408-482-9234