Provider Demographics
NPI:1689884918
Name:SHIN, ABRAHAM KYUNG (AC)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:KYUNG
Last Name:SHIN
Suffix:
Gender:M
Credentials:AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 W ORANGETHORPE AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-4405
Mailing Address - Country:US
Mailing Address - Phone:714-345-3292
Mailing Address - Fax:
Practice Address - Street 1:1817 W ORANGETHORPE AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-4405
Practice Address - Country:US
Practice Address - Phone:714-345-3292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9306171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist