MEDICARE: SPROUT WELLNESS ACUPUNCTURE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1255263943
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPROUT WELLNESS ACUPUNCTURE, INC.

Provider Business Mailing Address
First Line	:	1074 S PLYMOUTH BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-6898
Country	:	US
Telephone Number	:	213-302-2477
Fax Number	:

Provider Business Practice Location Address
First Line	:	1074 S PLYMOUTH BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-6898
Country	:	US
Telephone Number	:	213-302-2477
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ANNICE PARK
Credential	:	ACUPUNCTURIST
Telephone Number	:	213-302-2477

Provider Enumeration Date	:	05/29/2026
Last Update Date	:	05/29/2026

Similar Medicare Providers

1174196802 — SERA CHO
Practice Location Address:

1078 S PLYMOUTH BLVD
LOS ANGELES, CA
90019-6898

Practice Phone: 213-519-7997
Practice Fax:

1205097938 — CHRISTINA MARIE DOUGHERTY LCSW
Practice Location Address:

3705 W PICO BLVD # 790
LOS ANGELES, CA
90019-3451

Practice Phone: 858-504-7868
Practice Fax:

1265361075 — ERIC T. YEN
Practice Location Address:

5615 W PICO BLVD
LOS ANGELES, CA
90019-3835

Practice Phone: 323-528-7066
Practice Fax:

1952013203 — BROOKLYN RENEE' PAYTON MSW
Practice Location Address:

5630 VENICE BLVD # 1137
LOS ANGELES, CA
90019-5127

Practice Phone: 323-412-9241
Practice Fax:

1407131279 — YOUNGSOOK LEE HAN ACUPUNCTURIST
Practice Location Address:

903 CRENSHAW BLVD STE 302
LOS ANGELES, CA
90019-1967

Practice Phone: 323-938-1000
Practice Fax:

1225966336 — MS. SUSAN MORA
Practice Location Address:

1775 S OGDEN DR
LOS ANGELES, CA
90019-5036

Practice Phone: 323-854-6074
Practice Fax:

Directions to “SPROUT WELLNESS ACUPUNCTURE, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.