Provider Demographics
NPI:1740428739
Name:CHON, HYESOOK
Entity type:Individual
Prefix:
First Name:HYESOOK
Middle Name:
Last Name:CHON
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 1:3700 WILSHIRE BLVD
Mailing Address - Street 2:655
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2901
Mailing Address - Country:US
Mailing Address - Phone:213-973-7789
Mailing Address - Fax:213-232-0207
Practice Address - Street 1:3700 WILSHIRE BLVD
Practice Address - Street 2:655
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2901
Practice Address - Country:US
Practice Address - Phone:213-973-7789
Practice Address - Fax:213-232-0207
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-28
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12649171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist