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General NPI Number Information
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NPI Number | 1053995530
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Entity Type | Organization
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Legal Business Name | MEDITREE ACUPUNCTURE CLINIC INC
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Dates
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Enumeration Date | 05/10/2021
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 13519 HUBBARD ST
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City | SYLMAR
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State | CA
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Zip | 91342-4419
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Country | US
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Telephone | 818-833-5977
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Fax | 818-270-2919
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Provider Business Mailing Address
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Address Line | 609 PADILLA ST
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City | SAN GABRIEL
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State | CA
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Zip | 91776-1121
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Country | US
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Telephone | 818-833-5977
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Fax | 818-270-2919
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Authorized Official
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Title or Position | OWNER
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Name | HAELIM YANG
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Credential | ACUPUNCTURIST
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Telephone | 818-833-5977
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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 |
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License Number State |
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