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General NPI Number Information
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NPI Number | 1538325808
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Entity Type | Individual
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Provider Name | YOUNG GIL JANG LAC
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Gender | Male
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Dates
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Enumeration Date | 08/05/2008
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Last Update Date | 08/05/2008
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Provider Practice Location Address
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Address Line | 1133 S VERMONT AVE STE 22
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City | LOS ANGELES
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State | CA
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Zip | 90006-2764
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Country | US
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Telephone | 213-738-1033
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Fax | 213-738-7186
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Provider Business Mailing Address
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Address Line | 1133 S. VERMONT AVE. SUITE # 22
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City | LOS ANGELES
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State | CALIFORNIA
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Zip | 90006-2764
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Country | UM
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Telephone | 213-738-1033
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Fax | 213-738-7186
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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 | AC4573
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License Number State | CA
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