Healthcare Provider Details

I. General information

NPI: 1962306159
Provider Name (Legal Business Name): BADA ACPUNCTURE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 K ST UNIT 618
SAN DIEGO CA
92101-6995
US

IV. Provider business mailing address

350 K ST UNIT 618
SAN DIEGO CA
92101-6995
US

V. Phone/Fax

Practice location:
  • Phone: 619-734-9414
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateNULL

VIII. Authorized Official

Name: SEONGMIN LEE
Title or Position: ACPUNCTURIST
Credential: LAC
Phone: 585-733-8044