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General NPI Number Information
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NPI Number | 1609029776
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Entity Type | Organization
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Legal Business Name | NATURAL HEALING GROUP
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Dates
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Enumeration Date | 11/03/2008
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Last Update Date | 11/03/2008
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Provider Practice Location Address
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Address Line | 710 S BROOKHURST ST STE M
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City | ANAHEIM
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State | CA
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Zip | 92804-4321
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Country | US
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Telephone | 714-535-1727
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Fax |
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Provider Business Mailing Address
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Address Line | 710 S BROOKHURST ST. #M
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City | ANAHEIM
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State | CA
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Zip | 92804-4321
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Country | US
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Telephone | 714-535-1727
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIBONG SUK
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Credential | L.AC
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Telephone | 714-535-1727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | AC12007
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License Number State | CA
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