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General NPI Number Information
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NPI Number | 1578980322
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Entity Type | Organization
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Legal Business Name | SUN ACUPUNCTURE AND HERB CLINIC CORP
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Dates
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Enumeration Date | 03/18/2014
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Last Update Date | 02/23/2017
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Provider Practice Location Address
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Address Line | 1235 N. HARBOR BLVD STE # 111
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City | FULLERTON
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State | CA
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Zip | 92832-1323
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Country | US
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Telephone | 714-228-1182
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Fax | 714-871-4459
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Provider Business Mailing Address
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Address Line | 2271 W. MALVERN AVE STE # 403
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City | FULLERTON
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State | CA
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Zip | 92833
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Country | US
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Telephone | 714-228-1182
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Fax | 714-871-4459
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Authorized Official
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Title or Position | OWNER
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Name | JENNY SUN YEE
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Credential | L.AC
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Telephone | 714-228-1182
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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 | AC11200
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License Number State | CA
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