Provider Demographics
NPI:1770702136
Name:MOK, JAMES YOUNG (LAC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:YOUNG
Last Name:MOK
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:12722 MOLETTE ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-6824
Mailing Address - Country:US
Mailing Address - Phone:714-504-3662
Mailing Address - Fax:
Practice Address - Street 1:5860 EDINGER AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-1705
Practice Address - Country:US
Practice Address - Phone:714-840-0090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5872171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist