Provider Demographics
NPI:1700160538
Name:OWH, SOO HOON (ACUPUNCTURE)
Entity type:Individual
Prefix:
First Name:SOO
Middle Name:HOON
Last Name:OWH
Suffix:
Gender:M
Credentials:ACUPUNCTURE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3053 W OLYMPIC BLVD
Mailing Address - Street 2:#308
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2584
Mailing Address - Country:US
Mailing Address - Phone:213-385-7333
Mailing Address - Fax:
Practice Address - Street 1:3053 W OLYMPIC BLVD
Practice Address - Street 2:#308
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2584
Practice Address - Country:US
Practice Address - Phone:213-385-7333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12852171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist