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General NPI Number Information
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NPI Number | 1114449006
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Entity Type | Organization
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Legal Business Name | LA PALMA ACUPUNCTURE WELLNESS
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Dates
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Enumeration Date | 07/12/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5451 LA PALMA AVE STE 18
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City | LA PALMA
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State | CA
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Zip | 90623-1729
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Country | US
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Telephone | 714-592-3126
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Fax | 714-752-5833
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Provider Business Mailing Address
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Address Line | 5451 LA PALMA AVE STE 18
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City | LA PALMA
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State | CA
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Zip | 90623-1729
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Country | US
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Telephone | 714-592-3126
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Fax | 714-752-5833
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Authorized Official
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Title or Position | OWNER
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Name | SANG HEE SHIN
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Credential | LAC
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Telephone | 714-592-3126
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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 | AC7562
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License Number State | CA
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