Provider Demographics
NPI:1346529096
Name:HYUN, THOMAS (ACUPUNCTURIST)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:HYUN
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:
Other - Last Name:HYUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1919 W CORONET AVE
Mailing Address - Street 2:#107
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1755
Mailing Address - Country:US
Mailing Address - Phone:714-366-1240
Mailing Address - Fax:
Practice Address - Street 1:1919 W CORONET AVE
Practice Address - Street 2:#107
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1755
Practice Address - Country:US
Practice Address - Phone:714-366-1240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 14110171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist