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General NPI Number Information
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NPI Number | 1558586289
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Entity Type | Organization
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Legal Business Name | SOOL ACUPUNCTURE INC
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 14 SOUTHBROOK
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City | IRVINE
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State | CA
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Zip | 92604-3738
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Country | US
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Telephone | 949-651-5018
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Fax |
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Provider Business Mailing Address
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Address Line | 2027 MISSION AVE #C-1
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City | OCEANSIDE
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State | CA
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Zip | 92054
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Country | US
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Telephone | 760-269-3266
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Fax | 760-754-1819
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | MR. SOOL YEONG KIM
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Credential | LIC
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Telephone | 760-269-3266
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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 | 9923
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License Number State | CA
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