Provider Demographics
NPI:1467601435
Name:NAM, YOUNG WOO (AC)
Entity Type:Individual
Prefix:
First Name:YOUNG
Middle Name:WOO
Last Name:NAM
Suffix:
Gender:M
Credentials:AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1247 S CATALINA ST # E
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-3305
Mailing Address - Country:US
Mailing Address - Phone:213-703-5558
Mailing Address - Fax:213-365-1206
Practice Address - Street 1:1247 S CATALINA ST # E
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-3305
Practice Address - Country:US
Practice Address - Phone:213-703-5558
Practice Address - Fax:213-365-1206
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12181171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist