Healthcare Provider Details

I. General information

NPI: 1245529411
Provider Name (Legal Business Name): OIKOS ACUPUNCTURE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2011
Last Update Date: 03/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7850 EDGEWATER DR
OAKLAND CA
94621-2033
US

IV. Provider business mailing address

7850 EDGEWATER DR
OAKLAND CA
94621-2033
US

V. Phone/Fax

Practice location:
  • Phone: 510-639-7879
  • Fax: 510-639-7810
Mailing address:
  • Phone: 510-639-7879
  • Fax: 510-639-7810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 13652
License Number StateCA

VIII. Authorized Official

Name: MR. JAEHOON MOON
Title or Position: DIRECTOR
Credential: L.AC
Phone: 510-639-7879