Provider Demographics
NPI:1932637170
Name:HOU, POYUAN KEVIN (L AC)
Entity Type:Individual
Prefix:
First Name:POYUAN
Middle Name:KEVIN
Last Name:HOU
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:
Other - Last Name:HOU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:L AC
Mailing Address - Street 1:175 W LA VERNE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-2347
Mailing Address - Country:US
Mailing Address - Phone:909-741-7690
Mailing Address - Fax:844-309-1345
Practice Address - Street 1:175 W LA VERNE AVE STE B
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767
Practice Address - Country:US
Practice Address - Phone:909-741-7690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-01
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC17667171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist