Healthcare Provider Details

I. General information

NPI: 1003097429
Provider Name (Legal Business Name): CORE ACUPUNCTURE HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6031 BEACH BLVD
BUENA PARK CA
90621-2304
US

IV. Provider business mailing address

6031 BEACH BLVD
BUENA PARK CA
90621-2304
US

V. Phone/Fax

Practice location:
  • Phone: 714-994-1169
  • Fax:
Mailing address:
  • Phone: 714-994-1169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. YOUNGHEE PARK
Title or Position: PRESIDENT
Credential: D.C., L.AC., OMD
Phone: 714-994-1169