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General NPI Number Information
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NPI Number | 1316577927
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Entity Type | Organization
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Legal Business Name | ANGELUS GROUPS, INC.
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Dates
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Enumeration Date | 01/22/2020
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Last Update Date | 01/22/2020
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Provider Practice Location Address
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Address Line | 903 CRENSHAW BLVD STE 101
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City | LOS ANGELES
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State | CA
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Zip | 90019-1965
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Country | US
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Telephone | 213-247-5520
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Fax |
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Provider Business Mailing Address
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Address Line | 903 CRENSHAW BLVD STE 101
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City | LOS ANGELES
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State | CA
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Zip | 90019-1965
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Country | US
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Telephone | 213-247-5520
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | YOUNG TAE KIM
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Credential | DR.
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Telephone | 213-434-4593
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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 |
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License Number State |
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