Healthcare Provider Details
I. General information
NPI: 1972676062
Provider Name (Legal Business Name): OHAI ACUPUNCTURE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
925 E SAN ANTONIO DR SUITE #16
LONG BEACH CA
90807-2210
US
IV. Provider business mailing address
925 E SAN ANTONIO DR SUITE #16
LONG BEACH CA
90807-2210
US
V. Phone/Fax
- Phone: 562-423-2288
- Fax: 562-423-2299
- Phone: 562-423-2288
- Fax: 562-423-2299
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | LAC 5439 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
I LING
SUN
Title or Position: ACUPUNCTURIST
Credential: LAC
Phone: 562-423-2288