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General NPI Number Information
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NPI Number | 1215354162
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Entity Type | Organization
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Legal Business Name | JJ ACU & HERB CLINIC
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Dates
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Enumeration Date | 03/27/2014
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Last Update Date | 07/31/2018
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Provider Practice Location Address
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Address Line | 3680 WILSHIRE BLVD STE 108
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City | LOS ANGELES
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State | CA
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Zip | 90010
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Country | US
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Telephone | 213-263-2803
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Fax | 213-263-2869
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Provider Business Mailing Address
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Address Line | 821 CRENSHAW BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90005-3632
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | WOO HYUK CHUNG
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Credential | LAC., PHD
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Telephone | 323-933-9370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | AC8452
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License Number State | CA
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