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General NPI Number Information
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NPI Number | 1548537806
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Entity Type | Organization
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Legal Business Name | JK ACUPUNCTURE CLINIC, INC
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Dates
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Enumeration Date | 11/30/2011
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Last Update Date | 12/03/2014
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Provider Practice Location Address
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Address Line | 2001 S BARRINGTON AVE SUITE 212
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City | LOS ANGELES
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State | CA
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Zip | 90025-5363
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Country | US
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Telephone | 213-444-1155
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Fax | 213-402-5183
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Provider Business Mailing Address
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Address Line | 20435 S VERMONT AVE UNIT 2
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City | TORRANCE
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State | CA
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Zip | 90502-3150
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Country | US
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Telephone | 213-444-1155
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Fax | 213-402-5183
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Authorized Official
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Title or Position | CEO
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Name | JUNGKYO PARK
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Credential |
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Telephone | 213-444-1155
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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 | AC14491
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License Number State | CA
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