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General NPI Number Information
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NPI Number | 1306164983
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Entity Type | Organization
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Legal Business Name | BAIK ACUPUNCTURE CLINIC INC.
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Dates
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Enumeration Date | 05/06/2010
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Last Update Date | 05/06/2010
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Provider Practice Location Address
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Address Line | 13209 SOUTH ST
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City | CERRITOS
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State | CA
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Zip | 90703-7307
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Country | US
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Telephone | 562-860-6997
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Fax |
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Provider Business Mailing Address
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Address Line | 13209 SOUTH ST
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City | CERRITOS
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State | CA
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Zip | 90703-7307
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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 | L.AC
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Name | JONG SUN BAIK
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Credential |
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Telephone | 562-860-6997
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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 | AC10864
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License Number State | CA
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