Provider Demographics
NPI:1639389182
Name:YANG, YUN K
Entity Type:Individual
Prefix:
First Name:YUN
Middle Name:K
Last Name:YANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13400 W. WASHINGTON BLVD STE 202-A
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-5643
Mailing Address - Country:US
Mailing Address - Phone:310-306-1212
Mailing Address - Fax:
Practice Address - Street 1:13400 W. WASHINGTON BLVD STE 202-A
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-5643
Practice Address - Country:US
Practice Address - Phone:310-306-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 8364171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist