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General NPI Number Information
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NPI Number | 1275964744
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Entity Type | Organization
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Legal Business Name | YOHAN'S CLINIC
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Dates
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Enumeration Date | 12/09/2013
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 222 N MOUNTAIN AVE STE 102A
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City | UPLAND
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State | CA
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Zip | 91786-5733
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Country | US
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Telephone | 909-270-5819
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Fax | 909-639-6822
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Provider Business Mailing Address
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Address Line | 222 N MOUNTAIN AVE STE 102A
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City | UPLAND
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State | CA
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Zip | 91786-5733
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Country | US
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Telephone | 909-272-5819
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Fax | 909-639-6822
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Authorized Official
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Title or Position | PRESIDENT
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Name | YOHAN KO
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Credential |
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Telephone | 909-272-5819
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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 | AC13876
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License Number State | CA
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