Provider Demographics
NPI:1336524891
Name:DU, HYONGOAK
Entity Type:Individual
Prefix:
First Name:HYONGOAK
Middle Name:
Last Name:DU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30313 CANWOOD ST STE 23
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-2034
Mailing Address - Country:US
Mailing Address - Phone:818-889-8988
Mailing Address - Fax:818-889-7787
Practice Address - Street 1:30313 CANWOOD ST STE 23
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-2034
Practice Address - Country:US
Practice Address - Phone:818-889-8988
Practice Address - Fax:818-889-7787
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8586171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist