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General NPI Number Information
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NPI Number | 1154594497
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Entity Type | Organization
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Legal Business Name | LAFFA-ACU CLINIC
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Dates
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Enumeration Date | 04/08/2008
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Last Update Date | 09/19/2013
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Provider Practice Location Address
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Address Line | 1930 WILSHIRE BLVD STE 206
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City | LOS ANGELES
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State | CA
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Zip | 90057-3612
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Country | US
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Telephone | 213-483-1223
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Fax |
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Provider Business Mailing Address
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Address Line | 1930 WILSHIRE BLVD STE 206
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City | LOS ANGELES
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State | CA
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Zip | 90057-3612
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Country | US
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Telephone | 213-483-1223
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Fax | 213-483-1130
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Authorized Official
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Title or Position | CFO
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Name | SOPHIA RHEE
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Credential | L.AC
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Telephone | 213-483-1223
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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 | AC12353
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License Number State | CA
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