Healthcare Provider Details

I. General information

NPI: 1982187829
Provider Name (Legal Business Name): HAMA ACU CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2018
Last Update Date: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 SHATTO PL STE 205
LOS ANGELES CA
90020-1777
US

IV. Provider business mailing address

505 SHATTO PL STE 205
LOS ANGELES CA
90020-1777
US

V. Phone/Fax

Practice location:
  • Phone: 213-700-7902
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1364
License Number StateCA

VIII. Authorized Official

Name: WON KIM
Title or Position: OWNER
Credential:
Phone: 213-700-7902