Provider Demographics
NPI:1336343441
Name:YOO, JA HYUNG (ACUPUNCTURIST)
Entity Type:Individual
Prefix:MS
First Name:JA HYUNG
Middle Name:
Last Name:YOO
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4110 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-3406
Mailing Address - Country:US
Mailing Address - Phone:562-355-4825
Mailing Address - Fax:213-386-2582
Practice Address - Street 1:11635 FIRESTONE BLVD. #201
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90650-3406
Practice Address - Country:US
Practice Address - Phone:562-355-4825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11368171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist