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General NPI Number Information
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NPI Number | 1245529411
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Entity Type | Organization
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Legal Business Name | OIKOS ACUPUNCTURE CLINIC
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Dates
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Enumeration Date | 03/28/2011
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Last Update Date | 03/28/2011
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Provider Practice Location Address
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Address Line | 7850 EDGEWATER DR
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City | OAKLAND
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State | CA
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Zip | 94621-2033
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Country | US
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Telephone | 510-639-7879
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Fax | 510-639-7810
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Provider Business Mailing Address
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Address Line | 7850 EDGEWATER DR
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City | OAKLAND
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State | CA
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Zip | 94621-2033
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Country | US
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Telephone | 510-639-7879
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Fax | 510-639-7810
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. JAEHOON MOON
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Credential | L.AC
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Telephone | 510-639-7879
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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 | AC 13652
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License Number State | CA
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