Provider Demographics
NPI:1427596410
Name:YOM, EUN KYOUNG
Entity Type:Individual
Prefix:
First Name:EUN KYOUNG
Middle Name:
Last Name:YOM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25479 WHARTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:STEVENSON RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91381
Mailing Address - Country:US
Mailing Address - Phone:213-536-3550
Mailing Address - Fax:
Practice Address - Street 1:25479 WHARTON DR
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91381-1725
Practice Address - Country:US
Practice Address - Phone:213-536-3550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11567171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist