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General NPI Number Information
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NPI Number | 1437384997
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Entity Type | Organization
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Legal Business Name | JM ACUPUNCTURE INC
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Dates
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Enumeration Date | 05/27/2009
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Last Update Date | 05/27/2009
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Provider Practice Location Address
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Address Line | 17842 IRVINE BLVD 144
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City | TUSTIN
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State | CA
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Zip | 92780-3203
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Country | US
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Telephone | 714-505-8319
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Fax |
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Provider Business Mailing Address
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Address Line | 17842 IRVINE BLVD 144
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City | TUSTIN
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State | CA
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Zip | 92780-3203
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Country | US
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Telephone | 714-505-8319
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HYO PARK
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Credential | AC
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Telephone | 714-505-8319
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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 | AC12673
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License Number State | CA
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