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General NPI Number Information
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NPI Number | 1023808995
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Entity Type | Organization
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Legal Business Name | RED ACORN MEDICAL GROUP LLC
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 71 PURPLEJASMINE
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City | IRVINE
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State | CA
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Zip | 92620
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Country | US
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Telephone | 714-922-0017
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Fax |
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Provider Business Mailing Address
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Address Line | 1950 W CORPORATE WAY # 60175
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City | ANAHEIM
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State | CA
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Zip | 92801-5373
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Country | US
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Telephone | 714-922-0017
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Fax |
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Authorized Official
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Title or Position | NP
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Name | JAEWON LEE
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Credential | NP
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Telephone | 714-922-0017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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