Healthcare Provider Details

I. General information

NPI: 1023256849
Provider Name (Legal Business Name): SAEROM HERBS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2009
Last Update Date: 02/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14351 RED HILL AVE.
TUSTIN CA
92780-6271
US

IV. Provider business mailing address

14351 RED HILL AVE.
TUSTIN CA
92780-6271
US

V. Phone/Fax

Practice location:
  • Phone: 949-679-7494
  • Fax: 714-544-0099
Mailing address:
  • Phone: 949-679-7494
  • Fax: 714-544-0099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC10629
License Number StateCA

VIII. Authorized Official

Name: YANG HUN LEE
Title or Position: PRESIDENT
Credential:
Phone: 949-679-7494