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General NPI Number Information
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NPI Number | 1598047656
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Entity Type | Organization
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Legal Business Name | TJ ENERGY LLC
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Dates
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Enumeration Date | 09/15/2011
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Last Update Date | 09/15/2011
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Provider Practice Location Address
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Address Line | 905 S EUCLID ST # 1111
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City | FULLERTON
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State | CA
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Zip | 92832-2808
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Country | US
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Telephone | 714-366-1240
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1092
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City | CYPRESS
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State | CA
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Zip | 90630-1092
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Country | US
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Telephone | 714-366-1240
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | MR. THOMAS HYUN
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Credential | M OF OM
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Telephone | 714-366-1240
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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 | AC 14110
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License Number State | CA
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