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General NPI Number Information
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NPI Number | 1174859037
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Entity Type | Organization
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Legal Business Name | SAMRA ACUPUNCTURE SPINAL CENTER, INC.
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Dates
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Enumeration Date | 10/28/2009
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Last Update Date | 10/28/2009
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Provider Practice Location Address
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Address Line | 1730 W OLYMPIC BLVD SUITE 100
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City | LOS ANGELES
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State | CA
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Zip | 90015-1019
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Country | US
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Telephone | 213-384-1100
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Fax | 213-384-1101
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Provider Business Mailing Address
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Address Line | 1730 W OLYMPIC BLVD SUITE 100
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City | LOS ANGELES
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State | CA
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Zip | 90015-1019
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Country | US
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Telephone | 213-384-1100
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Fax | 213-384-1101
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Authorized Official
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Title or Position | PRESIDENT
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Name | HYUG YONG CHOI
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Credential | L.AC
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Telephone | 213-384-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC30810
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC12392
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC9503
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC12839
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License Number State | CA
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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 | AC10230
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License Number State | CA
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