Healthcare Provider Details

I. General information

NPI: 1568742468
Provider Name (Legal Business Name): HOLISTIC ACUPUNCTURE INCOPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2011
Last Update Date: 02/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 N GLENOAKS BLVD #204 A-1
BURBANK CA
91502-3201
US

IV. Provider business mailing address

539 N GLENOAKS BLVD #204 A-1
BURBANK CA
91502-3201
US

V. Phone/Fax

Practice location:
  • Phone: 818-300-3658
  • Fax:
Mailing address:
  • Phone: 818-300-3658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: JUEUY HONG
Title or Position: ACUPUNCTURE
Credential: L.AC
Phone: 818-300-3658