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General NPI Number Information
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NPI Number | 1376305078
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Entity Type | Organization
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Legal Business Name | SEOL ACUPUNCTURE GROUP, INC
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Dates
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Enumeration Date | 01/29/2024
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 680 LANGSDORF DR STE 210
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City | FULLERTON
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State | CA
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Zip | 92831-3702
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Country | US
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Telephone | 657-233-1221
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Fax | 657-255-4258
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Provider Business Mailing Address
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Address Line | 680 LANGSDORF DR STE 210
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City | FULLERTON
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State | CA
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Zip | 92831-3702
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Country | US
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Telephone | 657-233-1221
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Fax | 657-255-4258
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Authorized Official
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Title or Position | CEO
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Name | SA EUN SONG
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Credential | ACUPUNCTURIST
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Telephone | 657-233-1221
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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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