Healthcare Provider Details

I. General information

NPI: 1952694911
Provider Name (Legal Business Name): WMP&ACUMILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2011
Last Update Date: 05/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4482 BARRANCA PKWY STE 244
IRVINE CA
92604-4770
US

IV. Provider business mailing address

4482 BARRANCA PKWY STE 244
IRVINE CA
92604-4770
US

V. Phone/Fax

Practice location:
  • Phone: 949-551-8282
  • Fax: 949-313-0969
Mailing address:
  • Phone: 949-551-8282
  • Fax: 949-313-0969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC12700
License Number StateCA

VIII. Authorized Official

Name: MRS. HYUNSOOK LEE
Title or Position: VICE PRESIDENT
Credential:
Phone: 949-512-8282