Provider Demographics
NPI:1679755185
Name:RYU, JAY JAEMYONG (L AC)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:JAEMYONG
Last Name:RYU
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Gender:M
Credentials:L AC
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Mailing Address - Street 1:3808 W RIVERSIDE DR
Mailing Address - Street 2:SUITE 510
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4325
Mailing Address - Country:US
Mailing Address - Phone:818-841-9790
Mailing Address - Fax:818-841-9092
Practice Address - Street 1:121 S GLENOAKS BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1315
Practice Address - Country:US
Practice Address - Phone:818-841-9790
Practice Address - Fax:818-841-9092
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2016-04-22
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Provider Licenses
StateLicense IDTaxonomies
CAAC6016171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist