Healthcare Provider Details

I. General information

NPI: 1780386409
Provider Name (Legal Business Name): HERBS & NEEDLE ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 03/20/2023
Certification Date: 10/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 S GRAPE ST # 10
ESCONDIDO CA
92025-4407
US

IV. Provider business mailing address

106 S GRAPE ST # 10
ESCONDIDO CA
92025-4407
US

V. Phone/Fax

Practice location:
  • Phone: 213-568-5470
  • Fax:
Mailing address:
  • Phone: 213-568-5470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number State

VIII. Authorized Official

Name: HYOSHIN KWAK
Title or Position: OWNER
Credential: ACUPUNCTURIST
Phone: 213-568-5470