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General NPI Number Information
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NPI Number | 1003122631
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Entity Type | Organization
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Legal Business Name | DAE SANG ACUPUNCTURE CLINIC, INC.
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Dates
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Enumeration Date | 08/20/2010
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Last Update Date | 08/20/2010
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Provider Practice Location Address
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Address Line | 33 CREEK RD STE 270
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City | IRVINE
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State | CA
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Zip | 92604-7707
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Country | US
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Telephone | 949-769-3384
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Fax | 949-608-1924
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Provider Business Mailing Address
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Address Line | 33 CREEK RD STE 270
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City | IRVINE
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State | CA
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Zip | 92604-7707
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Country | US
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Telephone | 949-769-3384
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Fax | 949-608-1924
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES SHIN
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Credential | LAC, PHD
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Telephone | 949-769-3384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 9471
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License Number State | CA
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