Provider Demographics
NPI:1770164139
Name:YOUN, TAE SIK (ACUPUNCTURE)
Entity type:Individual
Prefix:
First Name:TAE SIK
Middle Name:
Last Name:YOUN
Suffix:
Gender:M
Credentials:ACUPUNCTURE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 S ARDMORE AVE
Mailing Address - Street 2:105
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-1345
Mailing Address - Country:US
Mailing Address - Phone:213-352-3157
Mailing Address - Fax:213-403-4155
Practice Address - Street 1:2787 E DEL AMO BLVD STE H5
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-6005
Practice Address - Country:US
Practice Address - Phone:213-352-3157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-17
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist