Provider Demographics
NPI:1871623181
Name:YOON, EUN HYE (LAC)
Entity type:Individual
Prefix:
First Name:EUN HYE
Middle Name:
Last Name:YOON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 S BEACH BLVD
Mailing Address - Street 2:SUITE G1
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-6377
Mailing Address - Country:US
Mailing Address - Phone:562-902-6400
Mailing Address - Fax:
Practice Address - Street 1:1401 S BEACH BLVD
Practice Address - Street 2:SUITE G1
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-6377
Practice Address - Country:US
Practice Address - Phone:562-902-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11325171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist