Provider Demographics
NPI:1346553641
Name:KANG, YOO JIN (DAOM, MSAOM, LAC)
Entity Type:Individual
Prefix:MS
First Name:YOO JIN
Middle Name:
Last Name:KANG
Suffix:
Gender:F
Credentials:DAOM, MSAOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 SILVER SPUR RD STE 208
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3680
Mailing Address - Country:US
Mailing Address - Phone:213-820-6015
Mailing Address - Fax:
Practice Address - Street 1:715 SILVER SPUR RD STE 208
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3680
Practice Address - Country:US
Practice Address - Phone:213-820-6015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16017171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist