Healthcare Provider Details

I. General information

NPI: 1619629144
Provider Name (Legal Business Name): JC ACUPUNCTURE & HERBS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2022
Last Update Date: 01/28/2022
Certification Date: 01/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 W LA HABRA BLVD
LA HABRA CA
90631-5408
US

IV. Provider business mailing address

1301 W SOUTHGATE AVE
FULLERTON CA
92833-4019
US

V. Phone/Fax

Practice location:
  • Phone: 714-392-3348
  • Fax:
Mailing address:
  • Phone: 714-392-3348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOY MYUNGYEON CHOI
Title or Position: OWNER
Credential: ACUPUNCTURIST
Phone: 714-392-3348