Provider Demographics
NPI:1225680879
Name:YEO, WOON MIN (DC, LAC)
Entity Type:Individual
Prefix:
First Name:WOON MIN
Middle Name:
Last Name:YEO
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 74601
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-0601
Mailing Address - Country:US
Mailing Address - Phone:669-235-9711
Mailing Address - Fax:
Practice Address - Street 1:3150 E IMPERIAL HWY STE 200
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-3226
Practice Address - Country:US
Practice Address - Phone:310-609-2827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-14
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18256171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No171100000XOther Service ProvidersAcupuncturist