Healthcare Provider Details

I. General information

NPI: 1861823874
Provider Name (Legal Business Name): FIRSONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2013
Last Update Date: 12/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4330 BARRANCA PKWY STE #232
IRVINE CA
92604-4755
US

IV. Provider business mailing address

40 SANTA CATALINA AISLE
IRVINE CA
92606-0860
US

V. Phone/Fax

Practice location:
  • Phone: 949-697-8582
  • Fax:
Mailing address:
  • Phone: 949-697-8582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC13550
License Number StateCA

VIII. Authorized Official

Name: MOON JUNG KIM
Title or Position: CEO
Credential: L.AC. PH.D
Phone: 949-697-8582