Provider Demographics
NPI:1467876391
Name:CHUN, HEE YOUNG (LAC DAOM)
Entity Type:Individual
Prefix:
First Name:HEE YOUNG
Middle Name:
Last Name:CHUN
Suffix:
Gender:F
Credentials:LAC DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13447 3/4 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2360
Mailing Address - Country:US
Mailing Address - Phone:323-919-9158
Mailing Address - Fax:
Practice Address - Street 1:13447 3/4 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-2360
Practice Address - Country:US
Practice Address - Phone:323-919-9158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13226171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist