Provider Demographics
NPI:1225420078
Name:YOU, YOUNG CHUN (LAC)
Entity Type:Individual
Prefix:
First Name:YOUNG CHUN
Middle Name:
Last Name:YOU
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 1:2075 HETEBRINK ST
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-5044
Mailing Address - Country:US
Mailing Address - Phone:610-331-1101
Mailing Address - Fax:
Practice Address - Street 1:2075 HETEBRINK ST
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-5044
Practice Address - Country:US
Practice Address - Phone:610-331-1101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15893171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist