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General NPI Number Information
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NPI Number | 1144604075
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Entity Type | Organization
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Legal Business Name | HYBRID MED INC.
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Dates
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Enumeration Date | 07/09/2015
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Last Update Date | 10/02/2015
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Provider Practice Location Address
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Address Line | 9943 CANOGA AVE
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City | CHATSWORTH
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State | CA
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Zip | 91311-3002
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Country | US
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Telephone | 323-337-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 16461 SHERMAN WAY SUITE 102
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City | LAKE BALBOA
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State | CA
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Zip | 91406-3842
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Country | US
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Telephone | 323-337-3000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLIE YOON
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Credential |
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Telephone | 818-389-4646
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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 | CA
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