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General NPI Number Information
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NPI Number | 1174957252
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Entity Type | Organization
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Legal Business Name | YONG ACUPUNCTURE & HERBS
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Dates
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Enumeration Date | 08/26/2013
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Last Update Date | 06/06/2014
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Provider Practice Location Address
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Address Line | 801 S. VERMONT AVE #204
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City | LOS ANGELES
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State | CA
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Zip | 90005
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Country | US
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Telephone | 213-480-3114
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Fax | 213-480-3114
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Provider Business Mailing Address
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Address Line | 801 S. VERMONT AVE #204
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City | LOS ANGELES
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State | CA
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Zip | 90005
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Country | US
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Telephone | 213-480-3114
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Fax | 213-480-3114
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Authorized Official
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Title or Position | OWNER
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Name | JOON HEE LEE
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Credential | LA.C
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Telephone | 818-967-9217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC14518
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License Number State | CA
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