Provider Demographics
NPI:1477925246
Name:HYUN, SANGKYOON (LAC)
Entity Type:Individual
Prefix:
First Name:SANGKYOON
Middle Name:
Last Name:HYUN
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 1:830 STEWART DR
Mailing Address - Street 2:201
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-4513
Mailing Address - Country:US
Mailing Address - Phone:408-515-7758
Mailing Address - Fax:
Practice Address - Street 1:830 STEWART DR
Practice Address - Street 2:201
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-4513
Practice Address - Country:US
Practice Address - Phone:408-515-7758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16660171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC 16660OtherCA ACUPUNCTURE BOARD