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General NPI Number Information
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NPI Number | 1487560058
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Entity Type | Organization
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Legal Business Name | EDEN ACUPUNCTURE & WELLNESS INC
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Dates
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Enumeration Date | 08/21/2026
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Last Update Date | 08/21/2026
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Provider Practice Location Address
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Address Line | 17501 IRVINE BLVD STE 103
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City | TUSTIN
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State | CA
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Zip | 92780-3147
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Country | US
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Telephone | 714-932-8512
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Fax | 949-390-9902
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Provider Business Mailing Address
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Address Line | 17501 IRVINE BLVD STE 103
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City | TUSTIN
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State | CA
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Zip | 92780-3147
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Country | US
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Telephone | 714-932-8512
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Fax | 949-390-9902
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Authorized Official
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Title or Position | CEO/CFO/SECRETARY
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Name | MR. SEOK LEE
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Credential | ACUPUNCTURIST
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Telephone | 714-932-8512
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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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