Provider Demographics
NPI:1265854251
Name:YEE, SUNGMIN (LAC)
Entity Type:Individual
Prefix:
First Name:SUNGMIN
Middle Name:
Last Name:YEE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:421 N BROOKHURST ST
Mailing Address - Street 2:#119
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-5637
Mailing Address - Country:US
Mailing Address - Phone:818-279-4401
Mailing Address - Fax:
Practice Address - Street 1:12706 BLOOMFIELD AVE,
Practice Address - Street 2:APT. 135
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650
Practice Address - Country:US
Practice Address - Phone:818-279-4401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-10
Last Update Date:2016-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15661171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist