Provider Demographics
NPI:1659865392
Name:YM LIFE TREE INC
Entity Type:Organization
Organization Name:YM LIFE TREE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HYEONGJIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:714-392-8962
Mailing Address - Street 1:13901 AMAR RD # AB7-8
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91746-1670
Mailing Address - Country:US
Mailing Address - Phone:714-392-8962
Mailing Address - Fax:626-364-3083
Practice Address - Street 1:13901 AMAR RD # AB7-8
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91746-1670
Practice Address - Country:US
Practice Address - Phone:714-392-8962
Practice Address - Fax:626-364-3083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-17
Last Update Date:2018-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16993171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty