Provider Demographics
NPI:1639943798
Name:YOO, HEATHER H (DACM)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:H
Last Name:YOO
Suffix:
Gender:F
Credentials:DACM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9921 CARMEL MOUNTAIN RD # 190
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2813
Mailing Address - Country:US
Mailing Address - Phone:858-449-5373
Mailing Address - Fax:858-408-3853
Practice Address - Street 1:4150 REGENTS PARK ROW STE 325
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-9102
Practice Address - Country:US
Practice Address - Phone:858-909-9033
Practice Address - Fax:858-429-4009
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA19925171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist