Provider Demographics
NPI:1962823971
Name:OH, DANIEL YOUNG (LAC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:YOUNG
Last Name:OH
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6073 NORTH FIRST ST.
Mailing Address - Street 2:SUITE #101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710
Mailing Address - Country:US
Mailing Address - Phone:559-449-0355
Mailing Address - Fax:559-449-0356
Practice Address - Street 1:6073 NORTH FIRST ST.
Practice Address - Street 2:SUITE #101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710
Practice Address - Country:US
Practice Address - Phone:559-449-0355
Practice Address - Fax:559-449-0356
Is Sole Proprietor?:No
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15681171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist