Provider Demographics
NPI:1568665347
Name:PARK, HOON KYUNG (LAC, QME)
Entity Type:Individual
Prefix:
First Name:HOON KYUNG
Middle Name:
Last Name:PARK
Suffix:
Gender:M
Credentials:LAC, QME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3171 LOS FELIZ BLVD
Mailing Address - Street 2:#304
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-1527
Mailing Address - Country:US
Mailing Address - Phone:323-913-0023
Mailing Address - Fax:323-913-0039
Practice Address - Street 1:3171 LOS FELIZ BLVD
Practice Address - Street 2:#304
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-1527
Practice Address - Country:US
Practice Address - Phone:323-913-0023
Practice Address - Fax:323-913-0039
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11265171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist