Healthcare Provider Details

I. General information

NPI: 1750013173
Provider Name (Legal Business Name): JNJ ACUPUNCTURE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2022
Last Update Date: 06/24/2022
Certification Date: 06/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5832 BEACH BLVD UNIT 207
BUENA PARK CA
90621-5501
US

IV. Provider business mailing address

5832 BEACH BLVD UNIT 207
BUENA PARK CA
90621-5501
US

V. Phone/Fax

Practice location:
  • Phone: 714-228-0077
  • Fax:
Mailing address:
  • Phone: 714-228-0077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SUN YOUNG CHUNG
Title or Position: OWNER
Credential: L.AC
Phone: 714-228-0077