Provider Demographics
NPI:1952604035
Name:HYUN, MYUNG HO (PHD, LAC)
Entity Type:Individual
Prefix:DR
First Name:MYUNG HO
Middle Name:
Last Name:HYUN
Suffix:
Gender:F
Credentials:PHD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17575 YUKON AVE APT J3
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-3444
Mailing Address - Country:US
Mailing Address - Phone:213-258-9959
Mailing Address - Fax:
Practice Address - Street 1:1045 W. REDONDO BEACH BLVD. SUITE 110
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247
Practice Address - Country:US
Practice Address - Phone:213-258-9959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13185171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist