Provider Demographics
NPI:1114203494
Name:KANG, BYEONG-SEON (LAC)
Entity Type:Individual
Prefix:MR
First Name:BYEONG-SEON
Middle Name:
Last Name:KANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-2515
Mailing Address - Country:US
Mailing Address - Phone:213-385-7979
Mailing Address - Fax:213-388-7975
Practice Address - Street 1:3411 W 8TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-2515
Practice Address - Country:US
Practice Address - Phone:213-385-7979
Practice Address - Fax:213-388-7975
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12668171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist