Provider Demographics
NPI:1952724528
Name:KANG, HYE SEON
Entity Type:Individual
Prefix:
First Name:HYE SEON
Middle Name:
Last Name:KANG
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 1:17127 PIONEER BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-2757
Mailing Address - Country:US
Mailing Address - Phone:562-650-7170
Mailing Address - Fax:
Practice Address - Street 1:17127 PIONEER BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-2757
Practice Address - Country:US
Practice Address - Phone:562-650-7170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-01
Last Update Date:2014-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12422171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist