Healthcare Provider Details

I. General information

NPI: 1215437934
Provider Name (Legal Business Name): SUN'S HOLISTIC ACUPUNCTURE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2018
Last Update Date: 02/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2551 BEVERLY BLVD # E
LOS ANGELES CA
90057-1020
US

IV. Provider business mailing address

2551 BEVERLY BLVD # E
LOS ANGELES CA
90057-1020
US

V. Phone/Fax

Practice location:
  • Phone: 213-384-0414
  • Fax:
Mailing address:
  • Phone: 213-384-0414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number3345
License Number StateCA

VIII. Authorized Official

Name: SUN OK JOO
Title or Position: PRESIDENT
Credential: LAC
Phone: 213-384-0414