Provider Demographics
NPI:1124166756
Name:KWON, YEUNG HWA (LAC, PHD, OMD)
Entity type:Individual
Prefix:DR
First Name:YEUNG
Middle Name:HWA
Last Name:KWON
Suffix:
Gender:M
Credentials:LAC, PHD, OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23136 SAMUEL ST APT 109
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3814
Mailing Address - Country:US
Mailing Address - Phone:213-247-4655
Mailing Address - Fax:213-386-7583
Practice Address - Street 1:2897 W OLYMPIC BLVD STE 202
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2639
Practice Address - Country:US
Practice Address - Phone:213-386-7582
Practice Address - Fax:213-386-7583
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-04
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4960171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1051815OtherAMERICAN SPECIALTY HEALTH