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General NPI Number Information
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NPI Number | 1598184038
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Entity Type | Organization
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Legal Business Name | JADE SPRINGS ACUPUNCTURE & HERBS, INC.
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Dates
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Enumeration Date | 04/14/2014
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Last Update Date | 04/14/2014
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Provider Practice Location Address
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Address Line | 11500 W OLYMPIC BLVD STE 636
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City | LOS ANGELES
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State | CA
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Zip | 90064-1525
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Country | US
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Telephone | 424-248-9767
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Fax |
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Provider Business Mailing Address
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Address Line | 916 15TH ST APT 2
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City | SANTA MONICA
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State | CA
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Zip | 90403-3147
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Country | US
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Telephone | 424-248-9767
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. JANET CHUNG
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Credential | L.AC., DIPL.O.M.
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Telephone | 424-248-9767
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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 | 15738
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License Number State | CA
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