Provider Demographics
NPI:1932942828
Name:YANG, EUNHO (LAC)
Entity type:Individual
Prefix:MR
First Name:EUNHO
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 W REDONDO BEACH BLVD # 1179
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-4203
Mailing Address - Country:US
Mailing Address - Phone:217-552-5677
Mailing Address - Fax:
Practice Address - Street 1:15420 S WESTERN AVE STE E
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90249-4356
Practice Address - Country:US
Practice Address - Phone:310-733-7523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC19583171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist