Provider Demographics
NPI:1386810075
Name:AHN, SEUNG KUN (LAC)
Entity type:Individual
Prefix:
First Name:SEUNG
Middle Name:KUN
Last Name:AHN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1019 S HARVARD BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2403
Mailing Address - Country:US
Mailing Address - Phone:626-422-0096
Mailing Address - Fax:626-810-4842
Practice Address - Street 1:340 S FARRELL DR
Practice Address - Street 2:SUITE A110
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-7963
Practice Address - Country:US
Practice Address - Phone:760-416-0042
Practice Address - Fax:760-416-0142
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 10548171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist