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NPI Code Detail

MEDICARE: KWEON Y YOO AC

MEDICARE: KWEON Y YOO AC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturistAC6721CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AC6721OTHERCALICENSE

General Provider Information

NPI Number : 1194892646
Entity Type Code : Individual
Provider Name (Legal Business Name) : KWEON Y YOO AC
Provider Business Mailing Address
First Line : 3053 W OLYMPIC BLVD STE 305
Second Line :
City : LOS ANGELES
State : CA
Zip : 90006-2558
Country : US
Telephone Number : 213-251-9911
Fax Number : 213-380-3922
Provider Business Practice Location Address
First Line : 3053 W OLYMPIC BLVD STE 305
Second Line :
City : LOS ANGELES
State : CA
Zip : 90006-2558
Country : US
Telephone Number : 213-251-9911
Fax Number : 213-380-3922
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2006
Last Update Date : 04/02/2009

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Directions to “ KWEON Y YOO AC” Practice Location

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