Healthcare Provider Details
I. General information
NPI: 1487325106
Provider Name (Legal Business Name): ACUPROGROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/22/2021
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1437 W BEVERLY BLVD
MONTEBELLO CA
90640-4154
US
IV. Provider business mailing address
1437 W BEVERLY BLVD
MONTEBELLO CA
90640-4154
US
V. Phone/Fax
- Phone: 323-887-7575
- Fax:
- Phone: 323-887-7575
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
BONGCHOL
YI
Title or Position: OFFICER
Credential:
Phone: 323-887-7575