Healthcare Provider Details
I. General information
NPI: 1912505504
Provider Name (Legal Business Name): WITHEE ACUPUNCTURE A PROFESSIONAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/15/2020
Last Update Date: 10/15/2020
Certification Date: 10/15/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2820 SEPULVEDA BLVD
TORRANCE CA
90505-2803
US
IV. Provider business mailing address
2574 W 234TH ST
TORRANCE CA
90505-3115
US
V. Phone/Fax
- Phone: 310-325-8500
- Fax: 310-325-8502
- Phone: 310-776-0554
- Fax: 310-325-8502
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
VICTORIA
CHO
Title or Position: CEO
Credential: L. AC.
Phone: 310-776-0554