Provider Demographics
NPI:1831643543
Name:YOUNGWOO ACUPUCTURE & HERBS CLINIC
Entity Type:Organization
Organization Name:YOUNGWOO ACUPUCTURE & HERBS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:YOUNGWOO
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-820-3208
Mailing Address - Street 1:7002 MOODY ST STE 111A
Mailing Address - Street 2:
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-1181
Mailing Address - Country:US
Mailing Address - Phone:714-820-3208
Mailing Address - Fax:
Practice Address - Street 1:4372 ROBIN DR
Practice Address - Street 2:
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-1933
Practice Address - Country:US
Practice Address - Phone:714-886-7432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC17209171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty