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General NPI Number Information
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NPI Number | 1386029783
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE ONE CENTER, INC
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 31348 VIA COLINAS SUITE 105
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-3913
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Country | US
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Telephone | 818-575-9096
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Fax | 818-575-9098
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Provider Business Mailing Address
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Address Line | 31348 VIA COLINAS SUITE 105
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-3913
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Country | US
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Telephone | 818-575-9096
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Fax | 818-575-9098
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KYUNG H LEE
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Credential | L.AC
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Telephone | 323-470-3494
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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 | 12286
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License Number State | CA
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