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General NPI Number Information
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NPI Number | 1336586395
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Entity Type | Organization
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Legal Business Name | HAPPY MIND BODY SPIRIT INC
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Dates
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Enumeration Date | 05/31/2013
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Last Update Date | 12/09/2013
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Provider Practice Location Address
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Address Line | 2125 E THOUSAND OAKS BLVD B1
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-2942
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Country | US
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Telephone | 805-494-0123
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Fax | 805-494-0102
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Provider Business Mailing Address
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Address Line | 2125 E THOUSAND OAKS BLVD B1
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-2942
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Country | US
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Telephone | 805-494-0123
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Fax | 805-494-0102
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Authorized Official
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Title or Position | PRESIDENT
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Name | JUNGHOON LEE
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Credential | LAC
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Telephone | 805-494-0123
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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 | AC13859
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License Number State | CA
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