Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND1022 | CA |
NPI | 1134694888 |
---|---|
Provider Name | Dr. Boye Jeong |
First Address | Irvine, CA 92620-1758 |
Second Address | Lake Forest, CA 92630-1614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2018 |
Last Update Date | 09/10/2018 |