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General NPI Number Information
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NPI Number | 1316214802
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Entity Type | Individual
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Provider Name | TAE HOON OAK L.AC
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Gender | Male
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Dates
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Enumeration Date | 11/28/2011
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Last Update Date | 01/16/2013
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Provider Practice Location Address
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Address Line | 13151 BROOKHURST ST
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City | GARDEN GROVE
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State | CA
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Zip | 92843-1079
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Country | US
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Telephone | 714-539-1300
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Fax | 714-539-1302
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Provider Business Mailing Address
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Address Line | 5047 HANOVER CIR
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City | CYPRESS
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State | CA
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Zip | 90630-3652
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Country | US
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Telephone | 213-435-1952
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 6907
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License Number State | CA
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