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General NPI Number Information
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NPI Number | 1023331766
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Entity Type | Organization
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Legal Business Name | HARVEST HEALTH CLINIC FOR ACUPUNCTURE, INC.
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 06/14/2017
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Provider Practice Location Address
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Address Line | 801 N TUSTIN AVE 702
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City | SANTA ANA
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State | CA
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Zip | 92705-3612
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Country | US
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Telephone | 714-564-0226
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Fax | 866-406-6113
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Provider Business Mailing Address
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Address Line | 801 N TUSTIN AVE 302
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City | SANTA ANA
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State | CA
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Zip | 92705-3612
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Country | US
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Telephone | 714-564-0226
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Fax | 888-510-0082
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Authorized Official
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Title or Position | MEMBER
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Name | MRS. JUNGHWA SARAH PARK
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Credential | DAOM, MSAOM, LAC
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Telephone | 714-564-0226
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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 | AC13080
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC29675
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License Number State | CA
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