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NPI 1154914000

NPI 1154914000 : ABRAHAM ACUPUNCTURE & HEALTH CARE : FULLERTON, CA

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General NPI Number Information
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    NPI Number           |    1154914000
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    Entity Type          |    Organization 
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    Legal Business Name  |    ABRAHAM ACUPUNCTURE & HEALTH CARE 
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Dates
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    Enumeration Date     |    02/11/2021
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    Last Update Date     |    02/11/2021
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Provider Practice Location Address
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    Address Line         |    1817 W ORANGETHORPE AVE 
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    City                 |    FULLERTON
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    State                |    CA
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    Zip                  |    92833-4405
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    Country              |    US
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    Telephone            |    714-449-0911
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    Fax                  |    714-449-2005
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Provider Business Mailing Address
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    Address Line         |    1817 W ORANGETHORPE AVE 
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    City                 |    FULLERTON
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    State                |    CA
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    Zip                  |    92833-4405
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    Country              |    US
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    Telephone            |    714-449-0911
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    Fax                  |    714-449-2005
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Authorized Official
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    Title or Position    |    ACUPUNCTURIST
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    Name                 |     ABRAHAM K SHIN 
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    Credential           |    L.AC
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    Telephone            |    714-449-0911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    
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    License Number State |    
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Taxonomy #4
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    Taxonomy Code        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    
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    License Number State |    
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Taxonomy #5
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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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