Provider Demographics
NPI:1093923542
Name:KANG, YOON HEZ (LAC)
Entity Type:Individual
Prefix:MR
First Name:YOON
Middle Name:HEZ
Last Name:KANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2900 BRISTOL ST.
Mailing Address - Street 2:SUITE C-105
Mailing Address - City:COSTA MES
Mailing Address - State:CA
Mailing Address - Zip Code:92626
Mailing Address - Country:US
Mailing Address - Phone:714-557-9454
Mailing Address - Fax:714-968-7510
Practice Address - Street 1:2900 BRISTOL ST.
Practice Address - Street 2:SUITE C-105
Practice Address - City:COSTA MES
Practice Address - State:CA
Practice Address - Zip Code:92626
Practice Address - Country:US
Practice Address - Phone:714-557-9454
Practice Address - Fax:714-968-7510
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6492171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist