Provider Demographics
NPI:1780745992
Name:PAIK, JUNGHOON (LAC)
Entity type:Individual
Prefix:MR
First Name:JUNGHOON
Middle Name:
Last Name:PAIK
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:408 S BEACH BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-1864
Mailing Address - Country:US
Mailing Address - Phone:714-821-4823
Mailing Address - Fax:714-821-4825
Practice Address - Street 1:408 S BEACH BLVD STE 110
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-1864
Practice Address - Country:US
Practice Address - Phone:714-821-4823
Practice Address - Fax:714-821-4825
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 9139171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist