MEDICARE: MS. EUNYUN KWON 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
1	171100000X	Acupuncturist	AC6351	CA

General Provider Information

NPI Number	:	1922212661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EUNYUN KWON AC

Provider Business Mailing Address
First Line	:	2115 W VICTORIA AVE
Second Line	:	# 25
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-3178
Country	:	US
Telephone Number	:	323-788-4478
Fax Number	:

Provider Business Practice Location Address
First Line	:	3407 W 6TH ST
Second Line	:	# 608
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-2537
Country	:	US
Telephone Number	:	323-788-4478
Fax Number	:

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

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	07/08/2007

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