MEDICARE: SUNYOUNG MIN

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
1	171100000X	Acupuncturist	AC14745	CA

General Provider Information

NPI Number	:	1790024776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNYOUNG MIN

Provider Business Mailing Address
First Line	:	1387 N OXFORD AVE
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91104-2730
Country	:	US
Telephone Number	:	626-800-9086
Fax Number	:	626-808-0054

Provider Business Practice Location Address
First Line	:	1737 E WASHINGTON BLVD
Second Line	:	SUITE 2
City	:	PASADENA
State	:	CA
Zip	:	91104-2768
Country	:	US
Telephone Number	:	626-800-9086
Fax Number	:	626-808-0054

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2013
Last Update Date	:	02/11/2013

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Directions to “ SUNYOUNG MIN ” Practice Location

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