Provider Demographics
NPI:1023295755
Name:BYUN, HA YEON
Entity type:Individual
Prefix:
First Name:HA YEON
Middle Name:
Last Name:BYUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELLIE
Other - Middle Name:
Other - Last Name:BYUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4595 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-3828
Mailing Address - Country:US
Mailing Address - Phone:213-389-9456
Mailing Address - Fax:213-389-9125
Practice Address - Street 1:7205 GREENLEAF AVE
Practice Address - Street 2:SUITE B
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-1317
Practice Address - Country:US
Practice Address - Phone:562-945-8873
Practice Address - Fax:562-945-4324
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12075171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist