Healthcare Provider Details

I. General information

NPI: 1164678041
Provider Name (Legal Business Name): WITHEE ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2008
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 SEPULVEDA BLVD
TORRANCE CA
90505-2803
US

IV. Provider business mailing address

2820 SEPULVEDA BLVD
TORRANCE CA
90505-2803
US

V. Phone/Fax

Practice location:
  • Phone: 310-325-8500
  • Fax: 310-325-8502
Mailing address:
  • Phone: 310-325-8500
  • Fax: 310-325-8502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC12369
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC7350
License Number StateCA

VIII. Authorized Official

Name: DR. HYOUNBOK VICTORIA CHO
Title or Position: PRESIDENT
Credential: L.AC. PH.D.
Phone: 310-325-8500