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General NPI Number Information
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NPI Number | 1518117431
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Entity Type | Individual
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Provider Name | JAEWOO YOU L.AC.
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Gender | Male
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Dates
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Enumeration Date | 09/27/2008
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Last Update Date | 08/06/2014
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Provider Practice Location Address
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Address Line | 5001 WILSHIRE BLVD STE 205
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City | LOS ANGELES
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State | CA
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Zip | 90036-6104
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Country | US
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Telephone | 323-877-6420
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Fax | 323-978-4348
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Provider Business Mailing Address
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Address Line | 238 S SERRANO AVE APT 210
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City | LOS ANGELES
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State | CA
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Zip | 90004-5261
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Country | US
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Telephone | 213-820-2773
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Fax | 323-978-4348
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 12608
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License Number State | CA
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