Provider Demographics
NPI:1124154976
Name:YOO, YOUNG
Entity type:Individual
Prefix:
First Name:YOUNG
Middle Name:
Last Name:YOO
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 1:2322 BUTANO DR STE 107
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-0687
Mailing Address - Country:US
Mailing Address - Phone:916-485-2624
Mailing Address - Fax:916-485-2095
Practice Address - Street 1:2322 BUTANO DR STE 107
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-0687
Practice Address - Country:US
Practice Address - Phone:916-485-2624
Practice Address - Fax:916-485-2095
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC1601171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist