Provider Demographics
NPI:1922284041
Name:YOON, MOK KOO (LAC)
Entity Type:Individual
Prefix:DR
First Name:MOK
Middle Name:KOO
Last Name:YOON
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7915 GARDEN GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92841-4225
Mailing Address - Country:US
Mailing Address - Phone:714-894-3080
Mailing Address - Fax:714-894-4646
Practice Address - Street 1:7915 GARDEN GROVE BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-4225
Practice Address - Country:US
Practice Address - Phone:714-894-3080
Practice Address - Fax:714-894-4646
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6733171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist