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General NPI Number Information
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NPI Number | 1083867220
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Entity Type | Organization
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Legal Business Name | O HAENG ACUPUNCTURE,INC
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Dates
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Enumeration Date | 10/31/2008
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Last Update Date | 11/04/2008
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Provider Practice Location Address
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Address Line | 40680 CALIFORNIA OAKS RD SUITE 2-D
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City | MURRIETA
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State | CA
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Zip | 92562-5755
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Country | US
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Telephone | 951-696-2779
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Fax | 951-696-2778
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Provider Business Mailing Address
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Address Line | 40680 CALIFORNIA OAKS RD SUITE 2-D
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City | MURRIETA
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State | CA
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Zip | 92562-5755
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Country | US
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Telephone | 951-696-2779
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Fax | 951-696-2778
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Authorized Official
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Title or Position | OWNER/ACUPUNCTURIST
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Name | SEONGUK SHIM
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Credential | L.AC
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Telephone | 951-696-2779
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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 | AC10222
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License Number State | CA
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