Healthcare Provider Details

I. General information

NPI: 1144602020
Provider Name (Legal Business Name): CJ HEALTH&WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2015
Last Update Date: 06/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6881 STANTON AVE STE C1
BUENA PARK CA
90621-3675
US

IV. Provider business mailing address

6881 STANTON AVE STE C1
BUENA PARK CA
90621-3675
US

V. Phone/Fax

Practice location:
  • Phone: 714-523-7486
  • Fax: 714-523-7486
Mailing address:
  • Phone: 714-523-7486
  • Fax: 714-523-7486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRIS B KIM
Title or Position: PRESIDENT
Credential:
Phone: 714-523-7486