Provider Demographics
NPI:1740319110
Name:HWANG, KYEONG HEON (LAC)
Entity type:Individual
Prefix:MR
First Name:KYEONG HEON
Middle Name:
Last Name:HWANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 S WESTERN AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-4270
Mailing Address - Country:US
Mailing Address - Phone:213-384-7212
Mailing Address - Fax:
Practice Address - Street 1:555 S WESTERN AVE STE 201
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-4270
Practice Address - Country:US
Practice Address - Phone:213-384-7212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4676171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist