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General NPI Number Information
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NPI Number | 1598125296
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Entity Type | Organization
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Legal Business Name | NEWPORT ACUPUNCTURE CENTER
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Dates
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Enumeration Date | 02/24/2016
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Last Update Date | 04/05/2016
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Provider Practice Location Address
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Address Line | 2043 WESTCLIFF DR STE 301
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-5511
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Country | US
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Telephone | 949-244-8862
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Fax | 949-627-8299
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Provider Business Mailing Address
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Address Line | 2043 WESTCLIFF DR STE 301
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-5511
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Country | US
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Telephone | 949-244-8862
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Fax | 949-627-8299
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | BRIAN OH
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Credential | L.AC
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Telephone | 949-244-8862
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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 | L.AC9930
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License Number State | CA
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