Provider Demographics
NPI:1376781781
Name:YOON, JEPIL (LAC)
Entity Type:Individual
Prefix:
First Name:JEPIL
Middle Name:
Last Name:YOON
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 SUNNYCREST DR STE 2000
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3640
Mailing Address - Country:US
Mailing Address - Phone:714-773-7000
Mailing Address - Fax:714-870-5028
Practice Address - Street 1:1950 SUNNYCREST DR STE 2000
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3640
Practice Address - Country:US
Practice Address - Phone:714-773-7000
Practice Address - Fax:714-870-5028
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 12841171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist