Provider Demographics
NPI:1346460235
Name:NAM, BILLY HYONG GAK (ACUPUNCTURIST)
Entity Type:Individual
Prefix:DR
First Name:BILLY
Middle Name:HYONG GAK
Last Name:NAM
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 S MARIPOSA AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-3234
Mailing Address - Country:US
Mailing Address - Phone:213-505-7755
Mailing Address - Fax:
Practice Address - Street 1:1211 S MARIPOSA AVE
Practice Address - Street 2:APT 2
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-3234
Practice Address - Country:US
Practice Address - Phone:213-505-7755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5248171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist