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NPI Code Detail

MEDICARE: MR. DAVID TAE KWON OMD

MEDICARE:  MR. DAVID TAE  KWON  OMD
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
1171100000XAcupuncturistAC5098CA

General Provider Information

NPI Number : 1437371549
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID TAE KWON OMD
Provider Business Mailing Address
First Line : 2727 W 6TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-3111
Country : US
Telephone Number : 213-738-0712
Fax Number : 213-480-1332
Provider Business Practice Location Address
First Line : 2727 W 6TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-3111
Country : US
Telephone Number : 213-738-0712
Fax Number : 213-480-1332
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2007
Last Update Date : 07/08/2007

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Directions to “ MR. DAVID TAE KWON OMD” Practice Location

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