Provider Demographics
NPI:1629427851
Name:YOU, HYUN (LAC, DOM)
Entity Type:Individual
Prefix:
First Name:HYUN
Middle Name:
Last Name:YOU
Suffix:
Gender:F
Credentials:LAC, DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 S.LAFAYETTE PARK PL.
Mailing Address - Street 2:APT.229
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057
Mailing Address - Country:US
Mailing Address - Phone:215-820-6372
Mailing Address - Fax:
Practice Address - Street 1:8645 HAVEN AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4818
Practice Address - Country:US
Practice Address - Phone:213-559-7629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC17053171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist