Healthcare Provider Details

I. General information

NPI: 1548669377
Provider Name (Legal Business Name): KAIROS ACUPUNCTURE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2014
Last Update Date: 08/18/2014
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: 323-868-4171
  • Fax: 310-325-8502
Mailing address:
  • Phone: 323-868-4171
  • Fax: 310-325-8502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC12624
License Number StateCA

VIII. Authorized Official

Name: MR. PAUL NAMHUN CHO
Title or Position: CEO
Credential: L.AC.
Phone: 323-868-4171